Effects of abnormal functional connectivity in transcallosal cortex connecting to the corpus callosum on motor recovery in chronic stroke patients with severe hemiplegia
10.3969/j.issn.1001-1242.2024.08.007
- VernacularTitle:慢性脑卒中伴严重偏瘫患者经胼胝体相连皮质功能连接异常对运动恢复的影响
- Author:
Ling LIU
1
;
Limin SUN
;
Hewei WANG
Author Information
1. 华东师范大学物理与电子科学学院上海市磁共振重点实验室,上海市,200062
- Publication Type:Journal Article
- Keywords:
stroke;
resting-state functional magnetic resonance imaging;
functional connectivity;
motor dysfunction
- From:
Chinese Journal of Rehabilitation Medicine
2024;39(8):1130-1142
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To investigate the changes in functional connectivity in transcallosal cortex connecting to the corpus callosum and its relationship with upper limb motor recovery in chronic stroke patients with severe hemiplegia.Method:The resting-state functional magnetic resonance imaging(fMRI) data were collected from 25 chronic stroke with severe hemiplegia before and after one-month rehabilitation intervention,as well as from 32 healthycontrols(HCs). The anatomical automatic labeling(ALL) atlas was used to identify 32 pairs of homotopic cortex regions directly connected via the corpus callosum for regions of interest(ROI)-level functional connectivity analy-sis. Differences in functional connectivity within the affected hemisphere,unaffected hemispheres,and between hemispheres were compared within and between groups. Furthermore,the correlation between functional connec-tivity and upper limb motor function scores(Fugl-Meyer assessment of upper extremity,FMA-UE)was analyzed.Result:Compared with HCs,the whole intrahemispheric functional connectivity in the stroke groups had no sig-nificant differences before and after rehabilitation intervention,while the whole interhemispheric functional con-nectivity was significantly reduced(P<0.01,FDR correction). Especially,the functional connectivity of homotopic regions decreased more significantly than that of interhemispheric non-homotopic regions,which involved the pre-frontal,sensorimotor,parietal,temporal,and occipital lobes. For the stroke groups,functional connectivity between the ipsilesional medial orbital gyrus and contralesional medial frontal gyrus was significantly enhanced after the intervention,compared with that before the intervention(P<0.01,FDR correction). The correlation analysis showed that the whole interhemispheric functional connectivity before the intervention was significantly positively correlated with FMA-UE scores(r=0.590,P=0.004). Five interhemispheric functional connectivities were significant-ly positively correlated with FMA-UE scores before the intervention in the stroke group(P<0.05),including three interhemispheric functional connectivities between homologous regions(involving the opercular part of the inferior frontal gyrus,ventral premotor area and primary motor cortex),and the other two interhemispheric functional con-nectivities between non-homologous regions(involving one connectivity between the ipsilesional lateral orbital gy-rus and the contralesional orbital part of the inferior frontal gyrus,and another connectivity between the ipsile-sional inferior parietal lobule and the contralesional superamarginal gyrus). Additionally,three interhemispheric functional connectivities between non-homologous regions in the pre-intervention stroke group were significantly positively correlated with the change of FMA-UE scores(P<0.05),involving the primary motor cortex,primary sensory cortex,ventral premotor area and superior temporal gyrus. Compared post-with pre-intervention,there was no significant correlation between changes in functional connectivity and FMA-UE scores.Conclusion:The weakened interhemispheric functional connectivity in transcallosal cortical regions may be an important factor contributing to the persistent motor dysfunction in chronic stroke patients with severe hemiple-gia. The interhemispheric functional connectivities within the sensorimotor cortex and between the ipsilesional sensorimotor cortex and the contralesional superior temporal lobe are closely related to motor recovery,possi-bly may be used to predict motor recovery of the upper limb in chronic stroke patients with severe hemiplegia.
