Neuroplastic changes in resting-state functional connectivity after stroke rehabilitation

• Published in: Frontiers in human neuroscience Vol. 9; p. 546
• Main Authors: Fan, Yang-teng, Wu, Ching-yi, Liu, Ho-ling, Lin, Keh-chung, Wai, Yau-yau, Chen, Yao-liang
• Format: Journal Article
• Language: English
• Published: Switzerland Frontiers Research Foundation 06.10.2015; Frontiers Media S.A
• Subjects: Activities of daily living; Brain mapping; Brain research; Cerebral hemispheres; Cortex (motor); fMRI; functional connectivity; Functional magnetic resonance imaging; Medicine; Motor Cortex; Motor task performance; Neural networks; Neuroimaging; Neuroplasticity; Neuroscience; Occupational therapy; Recovery of function; Rehabilitation; robot; Robots; Stroke; Taiwan; robot; fMRI; rehabilitation; functional connectivity; motor cortex; stroke
• ISSN: 1662-5161; 1662-5161
• DOI: 10.3389/fnhum.2015.00546

Most neuroimaging research in stroke rehabilitation mainly focuses on the neural mechanisms underlying the natural history of post-stroke recovery. However, connectivity mapping from resting-state fMRI is well suited for different neurological conditions and provides a promising method to explore plastic changes for treatment-induced recovery from stroke. We examined the changes in resting-state functional connectivity (RS-FC) of the ipsilesional primary motor cortex (M1) in 10 post-acute stroke patients before and immediately after 4 weeks of robot-assisted bilateral arm therapy (RBAT). Motor performance, functional use of the affected arm, and daily function improved in all participants. Reduced interhemispheric RS-FC between the ipsilesional and contralesional M1 (M1-M1) and the contralesional-lateralized connections were noted before treatment. In contrast, greater M1-M1 functional connectivity and disturbed resting-state networks were observed after RBAT relative to pre-treatment. Increased changes in M1-M1 RS-FC after RBAT were coupled with better motor and functional improvements. Mediation analysis showed the pre-to-post difference in M1-M1 RS-FC was a significant mediator for the relationship between motor and functional recovery. These results show neuroplastic changes and functional recoveries induced by RBAT in post-acute stroke survivors and suggest that interhemispheric functional connectivity in the motor cortex may be a neurobiological marker for recovery after stroke rehabilitation.