Abram Sabrina J, Tsay Jonathan S, Yosef Heran, Reisman Darcy S, Kim Hyosub E
Department of Psychology, University of California, Berkeley, Berkeley, CA, USA.
Helen Wills Neuroscience Institute, University of California, Berkeley, CA, USA.
Neurorehabil Neural Repair. 2025 Mar;39(3):213-225. doi: 10.1177/15459683241309588. Epub 2025 Jan 3.
BackgroundWhile it is evident that stroke impairs motor control, it remains unclear whether stroke impacts motor adaptation-the ability to flexibly modify movements in response to changes in the body and the environment. The mixed results in the literature may be due to differences in participants' brain lesions, sensorimotor tasks, or a combination of both.ObjectiveWe first sought to better understand the overall impact of stroke on motor adaptation and then to delineate the impact of lesion hemisphere and sensorimotor task on adaptation poststroke.MethodsFollowing the Preferred Reporting Items for Systematic reviews and Meta-Analyses guidelines, we conducted a systematic review and meta-analysis of 18 studies comparing individuals poststroke to neurotypical controls, with each group consisting of over 200 participants.ResultsWe found that stroke impairs motor adaptation ( = -0.63; 95% confidence interval [-1.02, -0.24]), and that the extent of this impairment did not differ across sensorimotor tasks but may vary with the lesioned hemisphere. Specifically, we observed greater evidence for impaired adaptation in individuals with left hemisphere lesions compared to those with right hemisphere lesions.ConclusionsThis review not only clarifies the detrimental effect of stroke on motor adaptation but also underscores the need for finer-grained studies to determine precisely how various sensorimotor learning mechanisms are impacted. The current findings may guide future mechanistic and applied research at the intersection of motor learning and neurorehabilitation.
背景
虽然很明显中风会损害运动控制，但中风是否会影响运动适应——即根据身体和环境变化灵活调整运动的能力——仍不清楚。文献中的结果不一，可能是由于参与者脑损伤的差异、感觉运动任务的不同，或两者兼而有之。
目的
我们首先试图更好地了解中风对运动适应的总体影响，然后阐明损伤半球和感觉运动任务对中风后适应的影响。
方法
按照系统评价和Meta分析的首选报告项目指南，我们对18项研究进行了系统评价和Meta分析，这些研究将中风后的个体与神经典型对照进行比较，每组参与者超过200人。
结果
我们发现中风会损害运动适应（= -0.63；95%置信区间[-1.02, -0.24]），并且这种损害的程度在感觉运动任务中没有差异，但可能因损伤半球而异。具体而言，与右半球损伤的个体相比，我们观察到左半球损伤的个体在适应方面受损的证据更多。
结论
本综述不仅阐明了中风对运动适应的有害影响，还强调了需要进行更细致的研究，以准确确定各种感觉运动学习机制是如何受到影响的。目前的研究结果可能会指导未来在运动学习和神经康复交叉领域的机制研究和应用研究。
