title: Interpreting Intervention Induced Neuroplasticity with fMRI: The Case for Multimodal Imaging Strategies.
abstract: Direct measurement of recovery from brain injury is an important goal in neurorehabilitation, and requires reliable, objective, and interpretable measures of changes in brain function, referred to generally as "neuroplasticity." One popular imaging modality for measuring neuroplasticity is task-based functional magnetic resonance imaging (t-fMRI). In the field of neurorehabilitation, however, assessing neuroplasticity using t-fMRI presents a significant challenge. This commentary reviews t-fMRI changes commonly reported in patients with cerebral palsy or acquired brain injuries, with a focus on studies of motor rehabilitation, and discusses complexities surrounding their interpretations. Specifically, we discuss the difficulties in interpreting t-fMRI changes in terms of their underlying causes, that is, differentiating whether they reflect genuine reorganisation, neurological restoration, compensation, use of preexisting redundancies, changes in strategy, or maladaptive processes. Furthermore, we discuss the impact of heterogeneous disease states and essential t-fMRI processing steps on the interpretability of activation patterns. To better understand therapy-induced neuroplastic changes, we suggest that researchers utilising t-fMRI consider concurrently acquiring information from an additional modality, to quantify, for example, haemodynamic differences or microstructural changes. We outline a variety of such supplementary measures for investigating brain reorganisation and discuss situations in which they may prove beneficial to the interpretation of t-fMRI data.
authors.affiliation: The Australian e-Health Research Centre, CSIRO, Brisbane, QLD 4029, Australia; Queensland Cerebral Palsy and Rehabilitation Research Centre, School of Medicine, The University of Queensland, Brisbane, QLD, Australia.
authors.forename: Lee B
authors.initials: LB
authors.lastname: Reid
authors.affiliation: Queensland Cerebral Palsy and Rehabilitation Research Centre, School of Medicine, The University of Queensland, Brisbane, QLD, Australia.
authors.forename: Roslyn N
authors.initials: RN
authors.lastname: Boyd
authors.affiliation: School of Psychology and Queensland Brain Institute, The University of Queensland, St. Lucia, Brisbane, QLD, Australia.
authors.forename: Ross
authors.initials: R
authors.lastname: Cunnington
authors.affiliation: The Australian e-Health Research Centre, CSIRO, Brisbane, QLD 4029, Australia.
authors.forename: Stephen E
authors.initials: SE
authors.lastname: Rose
mesh_terms: D001930:Brain Injuries / Q000503:physiopathology / Q000534:rehabilitation*; D001931:Brain Mapping / Q000379:methods; D006801:Humans; D008279:Magnetic Resonance Imaging / Q000379:methods*; D064847:Multimodal Imaging; D009473:Neuronal Plasticity / Q000502:physiology*; D020127:Recovery of Function / Q000502:physiology*
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