The reorganization patterns of the sensorimotor cortex during motor recovery in chronic stroke with severe hemiplegia
10.3969/j.issn.1001-1242.2024.08.005
- VernacularTitle:慢性脑卒中重度偏瘫患者功能恢复的感觉运动皮质重组模式研究
- Author:
Qianwen LI
1
;
Limin SUN
;
Hewei WANG
Author Information
1. 华东师范大学 上海市磁共振重点实验室,上海市,200062
- Publication Type:Journal Article
- Keywords:
stroke;
functional magnetic resonance imaging;
sensorimotor cortex;
severe hemiplegia
- From:
Chinese Journal of Rehabilitation Medicine
2024;39(8):1111-1121
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To investigate the reorganization patterns of sensorimotor cortex (SMC) and their relationship with upper limb motor function recovery in chronic stroke with severe hemiplegia.Method:Functional magnetic resonance imaging(fMRI) data were collected from 34 chronic stroke patients with severe hemiplegia who performed the passive fist clutch task with the affected hand before and after four weeks of rehabilitation. Additionally,data were collected from 29 healthy controls(HCs) who executed the pas-sive fist clutch task with unilateral hand. Differences in activation of SMC and the lateralization index(LI) be-fore and after the rehabilitation intervention were compared in the stroke group,and the correlation analysis was conducted with the Fugl-Meyer Assessment of Upper Extremity (FMA-UE).Result:In the healthy control group,the passive handgrip task predominantly activated the contralateral SMC. In the stroke group,changes in contralateral SMC activation during the affected hand task were classified into three patterns:recruitment,focusing,and no activation. The recruitment pattern showed that the activation of contralateral SMC increased after the intervention compared with that before the intervention. The focusing pat-tern showed that the activation of contralateral SMC decreased after the intervention compared with that before the intervention. The no activation pattern showed that there was no activation of contralateral SMC before and after the intervention. The LI in the recruitment group was similar to the HCs after the intervention,and the LI in the focusing group deviated from the HCs and was significantly higher than that of the HCs after the intervention(P<0.01). The FMA-UE scores of the three activation pattern groups were significantly in-creased after the intervention(P<0.01),while there were no significant differences both in the absolute values and absolute change values of FMA-UE and FMA-UE scores before and after the intervention between the re-cruitment group and the focusing group. In addition,there was a significant negative correlation between the relative change of contralateral SMC activation and the relative change of FMA-UE scores in the focusing group(r=-0.662,P=0.014).Conclusion:Chronic stroke patients with severe hemiplegia exhibit different reorganization patterns in the SMC during upper limb motor function recovery,particularly phenomena of SMC recruitment and concentration activation. These findings suggest that motor function recovery in chronic stroke patients with severe hemiple-gia does not rely on a single cortical functional reorganization pattern.
