title: fMRI as a molecular imaging procedure for the functional reorganization of motor systems in chronic stroke.
abstract: Previous brain imaging studies suggest that stroke alters functional connectivity in motor execution networks. Moreover, current understanding of brain plasticity has led to new approaches in stroke rehabilitation. Recent studies showed a significant role of effective coupling of neuronal activity in the SMA (supplementary motor area) and M1 (primary motor cortex) network for motor outcome in patients after stroke. After a subcortical stroke, functional magnetic resonance imaging (fMRI) during movement reveals cortical reorganization that is associated with the recovery of function. The aim of the present study was to explore connectivity alterations within the motor-related areas combining motor fMRI with a novel MR-compatible hand-induced robotic device (MR_CHIROD) training. Patients completed training at home and underwent serial MR evaluation at baseline and after 8 weeks of training. Training at home consisted of squeezing a gel exercise ball with the paretic hand at ~75% of maximum strength for 1 h/day, 3 days/week. The fMRI analysis revealed alterations in M1, SMA, PMC (premotor cortex) and Cer (cerebellum) in both stroke patients and healthy controls after the training. Findings of the present study suggest that enhancement of SMA activity could benefit M1 dysfunction in stroke survivors. These results also indicate that connectivity alterations between motor areas might assist the counterbalance of a functionally abnormal M1 in chronic stroke survivors and possibly other patients with motor dysfunction.
authors.affiliation: NMR Surgical Laboratory, Massachusetts General Hospital and Shriners Burn Institute, Harvard Medical School, Boston, MA, USA.
authors.forename: Asimina
authors.initials: A
authors.lastname: Lazaridou
authors.forename: Loukas
authors.initials: L
authors.lastname: Astrakas
authors.forename: Dionyssios
authors.initials: D
authors.lastname: Mintzopoulos
authors.forename: Azadeh
authors.initials: A
authors.lastname: Khanchiceh
authors.forename: Aneesh
authors.initials: A
authors.lastname: Singhal
authors.forename: Michael
authors.initials: M
authors.lastname: Moskowitz
authors.forename: Bruce
authors.initials: B
authors.lastname: Rosen
authors.forename: Aria
authors.initials: A
authors.lastname: Tzika
mesh_terms: D001921:Brain / Q000000981:diagnostic imaging; D002531:Cerebellum / Q000502:physiology; D002908:Chronic Disease; D003430:Cross-Sectional Studies; D006801:Humans; D008279:Magnetic Resonance Imaging; D009044:Motor Cortex / Q000502:physiology; D009473:Neuronal Plasticity / Q000502:physiology; D011859:Radiography; D020127:Recovery of Function; D059629:Signal-To-Noise Ratio; D020521:Stroke / Q000000981:diagnostic imaging*
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