Feitosa Jamille Almeida, Casseb Raphael Fernandes, Camargo Alline, Brandao Alexandre Fonseca, Li Li Min, Castellano Gabriela
Gleb Wataghin Institute of Physics, University of Campinas - UNICAMP, Campinas, Brazil.
Brazilian Institute of Neuroscience and Neurotechnology - BRAINN, Campinas, Brazil.
Front Neurol. 2023 Oct 6;14:1241639. doi: 10.3389/fneur.2023.1241639. eCollection 2023.
Stroke is the leading cause of functional disability worldwide. With the increase of the global population, motor rehabilitation of stroke survivors is of ever-increasing importance. In the last decade, virtual reality (VR) technologies for rehabilitation have been extensively studied, to be used instead of or together with conventional treatments such as physiotherapy or occupational therapy. The aim of this work was to evaluate the GestureCollection VR-based rehabilitation tool in terms of the brain changes and clinical outcomes of the patients.
Two groups of chronic patients underwent a rehabilitation treatment with (experimental) or without (control) complementation with GestureCollection. Functional magnetic resonance imaging exams and clinical assessments were performed before and after the treatment. A functional connectivity graph-based analysis was used to assess differences between the connections and in the network parameters strength and clustering coefficient.
Patients in both groups showed improvement in clinical scales, but there were more increases in functional connectivity in the experimental group than in the control group.
The experimental group presented changes in the connections between the frontoparietal and the somatomotor networks, associative cerebellum and basal ganglia, which are regions associated with reward-based motor learning. On the other hand, the control group also had results in the somatomotor network, in its ipsilateral connections with the thalamus and with the motor cerebellum, which are regions more related to a purely mechanical activity. Thus, the use of the GestureCollection system was successfully shown to promote neuroplasticity in several motor-related areas.
中风是全球功能残疾的主要原因。随着全球人口的增加，中风幸存者的运动康复变得越来越重要。在过去十年中，用于康复的虚拟现实（VR）技术得到了广泛研究，可用于替代传统治疗方法（如物理治疗或职业治疗）或与之结合使用。这项工作的目的是从患者的大脑变化和临床结果方面评估基于GestureCollection的VR康复工具。
两组慢性患者接受了有（实验组）或无（对照组）GestureCollection辅助的康复治疗。在治疗前后进行了功能磁共振成像检查和临床评估。基于功能连接图的分析用于评估连接之间以及网络参数强度和聚类系数的差异。
两组患者的临床量表均有改善，但实验组的功能连接增加比对照组更多。
实验组在额顶叶与躯体运动网络、联合小脑和基底神经节之间的连接出现了变化，这些区域与基于奖励的运动学习相关。另一方面，对照组在躯体运动网络及其与丘脑和运动小脑的同侧连接方面也有结果，这些区域与纯粹的机械活动更相关。因此，成功证明了GestureCollection系统的使用可促进多个运动相关区域的神经可塑性。
