title: Virtual reality-induced cortical reorganization and associated locomotor recovery in chronic stroke: an experimenter-blind randomized study.
abstract: OBJECTIVE
  Virtual reality (VR) is a new promising computer-assisted technology to promote motor recovery in stroke patients. VR-induced neuroplasticity supporting locomotor recovery is not known. We investigated the effects of VR intervention on cortical reorganization and associated locomotor recovery in stroke patients.
  
  
  METHODS
  Ten chronic stroke patients were assigned randomly to either the control group or the VR group. VR was designed to provide interactive real-life practice environments in which practice parameters can be individualized to optimize motor relearning. Laterality index (LI) in the regions of interests (ROIs) and locomotor recovery were measured before and after VR using functional MRI (fMRI) and standardized locomotor tests, respectively. The t test and nonparametric test were performed to compare the mean differences at P<0.05.
  
  
  RESULTS
  There was a significant difference in the interval change in the LI score for the primary sensorimotor cortex (SMC) between the groups (P<0.05), indicating that VR practice produced a greater increase in LI for the control group. However, the interval changes in the other ROIs were not significantly different (P>0.05). Motor function was significantly improved after VR (P<0.05).
  
  
  CONCLUSIONS
  Our novel findings suggest that VR could induce cortical reorganization from aberrant ipsilateral to contralateral SMC activation. This enhanced cortical reorganization might play an important role in recovery of locomotor function in patients with chronic stroke. This is the first fMRI study in the literature that provides evidence for neuroplasticity and associated locomotor recovery after VR.
authors.affiliation: Hampton University, Phoenix Hall 219B, Hampton, VA 23668, USA. sung.you@hamptonu.edu
authors.forename: Sung H
authors.initials: SH
authors.lastname: You
authors.forename: Sung Ho
authors.initials: SH
authors.lastname: Jang
authors.forename: Yun-Hee
authors.initials: YH
authors.lastname: Kim
authors.forename: Mark
authors.initials: M
authors.lastname: Hallett
authors.forename: Sang Ho
authors.initials: SH
authors.lastname: Ahn
authors.forename: Yong-Hyun
authors.initials: YH
authors.lastname: Kwon
authors.forename: Joong Hwi
authors.initials: JH
authors.lastname: Kim
authors.forename: Mi Young
authors.initials: MY
authors.lastname: Lee
mesh_terms: D001921:Brain / Q000473:pathology; D002540:Cerebral Cortex / Q000473:pathology; D002544:Cerebral Infarction; D003198:Computer Simulation; D003201:Computers; D005260:Female; D005684:Gait; D006429:Hemiplegia; D006801:Humans; D008279:Magnetic Resonance Imaging / Q000379:methods; D008297:Male; D008875:Middle Aged; D009044:Motor Cortex / Q000473:pathology; D009048:Motor Skills; D009068:Movement; D009473:Neuronal Plasticity; D020127:Recovery of Function; D012046:Rehabilitation; D016037:Single-Blind Method; D020521:Stroke / Q000628:therapy*