title: The Neural Correlates of Long-Term Carryover following Functional Electrical Stimulation for Stroke.
abstract: Neurorehabilitation effective delivery for stroke is likely to be improved by establishing a mechanistic understanding of how to enhance adaptive plasticity. Functional electrical stimulation is effective at reducing poststroke foot drop; in some patients, the effect persists after therapy has finished with an unknown mechanism. We used fMRI to examine neural correlates of functional electrical stimulation key elements, volitional intent to move and concurrent stimulation, in a group of chronic stroke patients receiving functional electrical stimulation for foot-drop correction. Patients exhibited task-related activation in a complex network, sharing bilateral sensorimotor and supplementary motor activation with age-matched controls. We observed consistent separation of patients with and without carryover effect on the basis of brain responses. Patients who experienced the carryover effect had responses in supplementary motor area that correspond to healthy controls; the interaction between experimental factors in contralateral angular gyrus was seen only in those without carryover. We suggest that the functional electrical stimulation carryover mechanism of action is based on movement prediction and sense of agency/body ownership-the ability of a patient to plan the movement and to perceive the stimulation as a part of his/her own control loop is important for carryover effect to take place.
authors.affiliation: Department of Electronics, Information and Bioengineering, Polytechnic University of Milan, Via G. Colombo 40, 20133 Milan, Italy.
authors.forename: Marta
authors.initials: M
authors.lastname: Gandolla
authors.affiliation: UCLP Centre for Neurorehabilitation, Queen Square, London WC1N 3BG, UK; Sobell Department of Motor Neuroscience, UCL Institute of Neurology, Queen Square, London WC1N 3BG, UK; The National Hospital for Neurology and Neurosurgery, Queen Square, London WC1N 3BG, UK.
authors.forename: Nick S
authors.initials: NS
authors.lastname: Ward
authors.affiliation: Valduce Hospital, Villa Beretta Rehabilitation Center, Via N. Sauro 17, 23845 Costa Masnaga, Italy.
authors.forename: Franco
authors.initials: F
authors.lastname: Molteni
authors.affiliation: Valduce Hospital, Villa Beretta Rehabilitation Center, Via N. Sauro 17, 23845 Costa Masnaga, Italy.
authors.forename: Eleonora
authors.initials: E
authors.lastname: Guanziroli
authors.affiliation: Department of Electronics, Information and Bioengineering, Polytechnic University of Milan, Via G. Colombo 40, 20133 Milan, Italy.
authors.forename: Giancarlo
authors.initials: G
authors.lastname: Ferrigno
authors.affiliation: Department of Electronics, Information and Bioengineering, Polytechnic University of Milan, Via G. Colombo 40, 20133 Milan, Italy.
authors.forename: Alessandra
authors.initials: A
authors.lastname: Pedrocchi
mesh_terms: D000328:Adult; D001921:Brain / Q000000981:diagnostic imaging / Q000503:physiopathology*; D001931:Brain Mapping; D004599:Electric Stimulation Therapy; D005260:Female; D005684:Gait / Q000502:physiology; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D009068:Movement / Q000502:physiology; D009415:Nerve Net / Q000000981:diagnostic imaging / Q000503:physiopathology; D000066530:Neurological Rehabilitation / Q000379:methods*; D009473:Neuronal Plasticity / Q000502:physiology*; D020521:Stroke / Q000000981:diagnostic imaging / Q000503:physiopathology*; D000071939:Stroke Rehabilitation / Q000379:methods*; D055815:Young Adult