Neurorehabilitation-induced cortical reorganization in brain injury: a 14-month longitudinal follow-up study.
OBJECTIVE
This study highlights the effects of a comprehensive neurorehabilitation (CN) on neuroplasticity and motor recovery in a 25 years old adult with right hippocampal sclerosis and the temporal lobectomy and amygdalotomy.


METHODS
The patient received 8-month course of comprehensive neurorehabilitation, comprised of five times/week. Motor behavioral and 1.5 T functional magnetic resonance imaging (fMRI) tests were implemented to determine the restoration of motor function and neuroplasitic changes, respectively. In fMRI measure, a laterality index (LI) was used to determine any shift in the symmetry of cortical activation between the hemispheres. Additionally, motor behavioral changes were measured to probe long-term retention of learned motor skills at the 6-month post-treatment follow-up test.


RESULTS
Motor behavioral tests showed that comprehensive neurorehabilitation enhanced functional reaching, grasping, and hand manipulation skills, which were well retained even at the 6-month post-treatment. Baseline fMRI showed asymmetry of the contralesional sensori-motor cortex (SMC) activation (Laterality index score: 0.54), but was restored to normal symmetry (Lateral index: 1.0) during affected hand movement after comprehensive neurorehabilitation.


CONCLUSIONS
Our novel findings suggest that comprehensive neurorehabilitation may facilitate restitution of normal symmetry of cortical activation, thereby enhancing motor function. This case provides the first neuroimaging evidence about a long-term comprehensive neurorehabilitation-induced neuroplasticity of the individual with a complex brain injury in the literature.
Department of Physical Medicine & Rehabilitation, School of Medicine, Yeungnam University, Taegu, Republic of Korea.
Sung Ho
SH
Jang
Sung H
SH
You
Sang Ho
SH
Ahn
D000328:Adult; D038481:Anterior Temporal Lobectomy / Q000009:adverse effects; D002545:Brain Ischemia / Q000209:etiology / Q000503:physiopathology / Q000534:rehabilitation*; D005500:Follow-Up Studies; D006429:Hemiplegia / Q000209:etiology / Q000503:physiopathology / Q000534:rehabilitation*; D006801:Humans; D008297:Male; D009043:Motor Activity / Q000502:physiology*; D009044:Motor Cortex / Q000503:physiopathology*; D009473:Neuronal Plasticity / Q000502:physiology*; D020127:Recovery of Function / Q000502:physiology*; D012046:Rehabilitation / Q000379:methods; D013997:Time Factors