title: Functional organization and restoration of the brain motor-execution network after stroke and rehabilitation.
abstract: Multiple cortical areas of the human brain motor system interact coherently in the low frequency range (<0.1 Hz), even in the absence of explicit tasks. Following stroke, cortical interactions are functionally disturbed. How these interactions are affected and how the functional organization is regained from rehabilitative treatments as people begin to recover motor behaviors has not been systematically studied. We recorded the intrinsic functional magnetic resonance imaging (fMRI) signals from 30 participants: 17 young healthy controls and 13 aged stroke survivors. Stroke participants underwent mental practice (MP) or both mental practice and physical therapy (MP+PT) within 14-51 days following stroke. We investigated the network activity of five core areas in the motor-execution network, consisting of the left primary motor area (LM1), the right primary motor area (RM1), the left pre-motor cortex (LPMC), the right pre-motor cortex (RPMC) and the supplementary motor area (SMA). We discovered that (i) the network activity dominated in the frequency range 0.06-0.08 Hz for all the regions, and for both able-bodied and stroke participants (ii) the causal information flow between the regions: LM1 and SMA, RPMC and SMA, RPMC and LM1, SMA and RM1, SMA and LPMC, was reduced significantly for stroke survivors (iii) the flow did not increase significantly after MP alone and (iv) the flow among the regions during MP+PT increased significantly. We also found that sensation and motor scores were significantly higher and correlated with directed functional connectivity measures when the stroke-survivors underwent MP+PT but not MP alone. The findings provide evidence that a combination of mental practice and physical therapy can be an effective means of treatment for stroke survivors to recover or regain the strength of motor behaviors, and that the spectra of causal information flow can be used as a reliable biomarker for evaluating rehabilitation in stroke survivors.
authors: Department of Physics and Astronomy, Georgia State University Atlanta, GA, USA.
authors: Sahil
authors: S
authors: Bajaj
authors: Department of Physical Therapy, Byrdine F. Lewis School of Nursing and Health Professions, Georgia State University Atlanta, GA, USA ; Department of Veteran's Affairs, Atlanta Rehabilitation Research and Development Center of Excellence Decatur, GA, USA ; Neuroscience Institute, Joint Center for Advanced Brain Imaging, Center for Behavioral Neuroscience, Georgia State University Atlanta, GA, USA.
authors: Andrew J
authors: AJ
authors: Butler
authors: Department of Physical Therapy, Byrdine F. Lewis School of Nursing and Health Professions, Georgia State University Atlanta, GA, USA.
authors: Daniel
authors: D
authors: Drake
authors: Department of Physics and Astronomy, Georgia State University Atlanta, GA, USA ; Neuroscience Institute, Joint Center for Advanced Brain Imaging, Center for Behavioral Neuroscience, Georgia State University Atlanta, GA, USA.
authors: Mukesh
authors: M
authors: Dhamala
keywords: brain network activity; functional magnetic resonance imaging; low-frequency oscillations; spectral Granger causality; stroke recovery