| Application of functional MRI in upper-limb stroke hemiplegia treated with computer-assisted exercise |
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| DOI： |
| EN KeyWords: ischemic stroke computer-assisted training functional MRI rehabilitation |
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| EN Abstract: |
| Objective:To investigate the effects of computer-assisted intervention on cortical reorganization and associated motor recovery. Methods:Ten stroke patients treated with computer-assisted exercise were assessed with Hong Kong Edition of Functional Test for Hemiplegic Upper Extremity Scale (FTHUE-HK), Fugl-Meyer Motor Assessment (FMA) and Modified Barthel Index (MBI) before and after the treatment. Functional MRI (fMRI) with 1.5T scanner was performed at the time of the subjects attempting sequential wrist flexion-extension before and after treatment. Results:(1) Computer assisted therapy showed improvements in FTHUE-HK, FMA and MBI at 6th week after treatment (P<0.05). (2) Prior to computer-assisted exercise, contralateral primary sensorimotor cortex (SMC) and ipsilateral cerebellum were activated during the motor task with unaffected hand of patients; After computer-assisted exercise, the activated areas of uninjured side hand of patients were increased in contralateral primary sensorimotor cortex (SMC) and part of the limbic system. (3) Before the training, the brain maps showed scattered activity in the contralateral primary SMC, and the ipsilateral SMC and SMA were increased during the affected wrist movement. After 6-week training, during the paretic wrist movement, activated regions were mainly located in the contralateral and ipsilateral SMC, SMA, contralateral primary SMC and contralateral parietal lobule, and the intensity of contralateral SMC was significantly increased as compared with those before treatment.Conclusion: Computer-assisted exercise can improve the upper limb function after stroke, which is mainly contributed to the function remodeling of the brain cortex. |
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