Delion Timo, Jacquemont Thomas, Daghsen Lina, Valabregue Romain, Beanato Elena, Hummel Friedhelm, Moulton Eric, Zavanone Chiara, Dupont Sophie, Gallea Cécile, Rosso Charlotte
Inserm U 1127, CNRS UMR 7225, Sorbonne Université, UPMC Univ Paris 06, UMR S 1127, Institut du Cerveau, ICM, Paris, F-75013, France.
STARE Team, iCRIN, Institut du Cerveau, ICM, Paris, France.
Cerebellum. 2025 Jan 9;24(1):28. doi: 10.1007/s12311-024-01783-x.
Cerebellar functional and structural connectivity are likely related to motor function after stroke. Less is known about motor recovery, which is defined as a gain of function between two time points, and about the involvement of the cerebellum. Fifteen patients who were hospitalized between 2018 and 2020 for a first cerebral ischemic event with persistent upper limb deficits were assessed by resting-state functional MRI (rsfMRI) and clinical motor score measurements at 3, 9 and 15 weeks after stroke. Age- and sex-matched healthy subjects (n = 15) were assessed once. The objectives were (1) to study whether the level of connectivity between the contralesional cerebellum (lobules IV-V-VI and lobule VIII) and the ipsilesional motor regions on rsfMRI is predictive of motor recovery and (2) to compare these connectivities with those of healthy subjects. Upper limb motor recovery was positively correlated with functional connectivity between contralesional cerebellar lobule VIII and the ipsilesional supplementary motor area (SMA). The greater the connectivity between these regions, the better the motor recovery. In patients, the corticocerebellar network between lobule IV-V-VI and the ipsilesional M1 and SMA showed weaker synchronization at rest than in healthy subjects. Cortico-cortical connectivity was not associated with recovery. Resting-state functional connectivity, including contralesional cerebellar lobule VIII, could be a tool for studying and predicting recovery in stroke patients. Our study highlights the role of the cerebellum in motor recovery after stroke, enabling us to consider new therapeutic targets in neuromodulation.
小脑的功能和结构连接可能与中风后的运动功能有关。关于运动恢复(定义为两个时间点之间功能的改善)以及小脑在其中的作用,我们了解得较少。对2018年至2020年间因首次脑缺血事件住院且存在持续性上肢功能缺损的15名患者,在中风后3周、9周和15周通过静息态功能磁共振成像(rsfMRI)和临床运动评分测量进行评估。对年龄和性别匹配的健康受试者(n = 15)进行了一次评估。目的是:(1)研究rsfMRI上患侧小脑(小叶IV-V-VI和小叶VIII)与同侧运动区域之间的连接水平是否可预测运动恢复;(2)将这些连接与健康受试者的连接进行比较。上肢运动恢复与患侧小脑小叶VIII和同侧辅助运动区(SMA)之间的功能连接呈正相关。这些区域之间的连接越强,运动恢复越好。在患者中,小叶IV-V-VI与同侧M1和SMA之间的皮质小脑网络在静息时的同步性比健康受试者弱。皮质-皮质连接与恢复无关。包括患侧小脑小叶VIII在内的静息态功能连接可能是研究和预测中风患者恢复情况的一种工具。我们的研究突出了小脑在中风后运动恢复中的作用,使我们能够考虑神经调节方面的新治疗靶点。