title: Association of activity changes in the primary sensory cortex with successful motor rehabilitation of the hand following stroke.
abstract: BACKGROUND
  Previous studies demonstrated a posterior shift of activation toward the primary sensory cortex (S1) following stroke; however, any relationship between this posterior shift and clinical outcome measures for the affected hand function were unclear.
  
  
  OBJECTIVE
  The authors investigated the possible role of S1 in motor recovery.
  
  
  METHODS
  Assuming that previous studies examined inhomogeneous groups of patients, the authors selected participants with chronic stroke who had moderate hand paresis, normal sensory examination and somatosensory-evoked potentials, and no lesion within the S1, thalamus, or brain stem. Constraint-induced movement therapy (CIMT) was used to train the impaired hand. To relate fMRI (functional MRI) activation changes from baseline to post-CIMT, a correlation analysis was performed with changes of the Wolf Motor Function Test (WMFT) as a test for the hand function.
  
  
  RESULTS
  A close relationship was found between increases in hand function and peak changes in activation within the ipsilesional S1. With a better outcome, greater increases in activation within the S1 were evident (P < .03; r = 0.73).
  
  
  CONCLUSIONS
  In selected patients, the sensory network influences training-induced motor gains. This predictive knowledge of plasticity when applying CIMT may suggest strategies to enhance the effect of therapy, such as the addition of electrical stimulation to enhance S1 excitability.
authors.affiliation: University Clinic of Freiburg, Freiburg, Germany. monalaible@googlemail.com
authors.forename: Mona
authors.initials: M
authors.lastname: Laible
authors.forename: Steven
authors.initials: S
authors.lastname: Grieshammer
authors.forename: Gundula
authors.initials: G
authors.lastname: Seidel
authors.forename: Michel
authors.initials: M
authors.lastname: Rijntjes
authors.forename: Cornelius
authors.initials: C
authors.lastname: Weiller
authors.forename: Farsin
authors.initials: F
authors.lastname: Hamzei
mesh_terms: D000368:Aged; D005081:Exercise Therapy / Q000379:methods*; D005260:Female; D006225:Hand / Q000503:physiopathology*; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D009473:Neuronal Plasticity / Q000502:physiology; D009483:Neuropsychological Tests; D010291:Paresis / Q000209:etiology / Q000534:rehabilitation; D012720:Severity of Illness Index; D013003:Somatosensory Cortex / Q000503:physiopathology*; D020521:Stroke / Q000150:complications; D000071939:Stroke Rehabilitation