Arm Training Induced Brain Plasticity in Stroke Studied with Serial Positron Emission Tomography

Nelles, Gereon; Jentzen, Walter; Jueptner, M.; Müller, Silke M.; Diener, Hans‐Christoph

doi:10.1006/nimg.2001.0757

Cited by 233 publications

(138 citation statements)

References 26 publications

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“…Recovery of function depends in part on the postinjury experience, and plasticity or reorganizational potential may be enhanced by activity. Enhanced movement therapy for the paretic arm of recovering stroke patients led to significant regional cerebral blood flow improvements compared with those receiving standard care [33]. Work with animal models also indicates that training enhances recovery after central nervous system damage.…”

Section: Activity-dependent Plasticitymentioning

confidence: 98%

Motions or muscles? Some behavioral factors underlying robotic assistance of motor recovery

Hogan

Krebs²,

Rohrer³

et al. 2006

JRRD

328

200

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Abstract-Robotics and related technologies have begun to realize their promise to improve the delivery of rehabilitation therapy. However, the mechanism by which they enhance recovery remains unclear. Ultimately, recovery depends on biology, yet the details of the recovery process remain largely unknown; a deeper understanding is important to accelerate refinements of robotic therapy or suggest new approaches. Fortunately, robots provide an excellent instrument platform from which to study recovery at the behavioral level. This article reviews some initial insights about the process of upper-limb behavioral recovery that have emerged from our work. Evidence to date suggests that the form of therapy may be more important than its intensity: muscle strengthening offers no advantage over movement training. Passive movement is insufficient; active participation is required. Progressive training based on measures of movement coordination yields substantially improved outcomes. Together these results indicate that movement coordination rather than muscle activation may be the most appropriate focus for robotic therapy.

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Section: Activity-dependent Plasticitymentioning

confidence: 98%

Motions or muscles? Some behavioral factors underlying robotic assistance of motor recovery

Hogan

Krebs²,

Rohrer³

et al. 2006

JRRD

328

200

View full text Add to dashboard Cite

show abstract

“…Few studies have related behavioral gains to changes within cerebral sensorimotor regions of interest (ROIs) over the course of a specific therapy or general approach to rehabilitation (Carey et al, 2002;Johansen-Berg et al, 2002;Liepert et al, 2000;Nelles et al, 2001;Ward et al, 2003b;Wittenberg et al, 2003). To do so convincingly, investigators could employ (1) a well-defined rehabilitation strategy that emphasizes the practice of functionally important movements, (2) an activation paradigm during neuroimaging that incorporates components of the movements being retrained, (3) changes in activated regions of interest over time in relation to the intensity or duration of the rehabilitation strategy, and (4) behavioral outcome measures that monitor, with adequate sensitivity, the gains over time that are relevant to what was practiced (Dobkin, 2003b).…”

Section: Introductionmentioning

confidence: 99%

Ankle dorsiflexion as an fMRI paradigm to assay motor control for walking during rehabilitation

et al. 2004

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The ability to walk independently with the velocity and endurance that permit home and community activities is a highly regarded goal for neurological rehabilitation after stroke. This pilot study explored a functional magnetic resonance imaging (fMRI) activation paradigm for its ability to reflect phases of motor learning over the course of locomotor rehabilitation-mediated functional gains. Ankle dorsiflexion is an important kinematic aspect of the swing and initial stance phase of the gait cycle. The motor control of dorsiflexion depends in part on descending input from primary motor cortex. Thus, an fMRI activation paradigm using voluntary ankle dorsiflexion has face validity for the serial study of walking-related interventions. Healthy control subjects consistently engaged contralateral primary sensorimotor cortex (S1M1), supplementary motor area (SMA), premotor (PM) and cingulate motor (CMA) cortices, and ipsilateral cerebellum. Four adults with chronic hemiparetic stroke evolved practice-induced representational plasticity associated with gains in speed, endurance, motor control, and kinematics for walking. For example, an initial increase in activation within the thoracolumbar muscle representation of S1M1 in these subjects was followed by more focused activity toward the foot representation with additional pulses of training. Contralateral CMA and the secondary sensory area also reflected change with practice and gains. We demonstrate that the supraspinal sensorimotor network for the neural control of walking can be assessed indirectly by ankle dorsiflexion. The ankle paradigm may serve as an ongoing physiological assay of the optimal type, duration, and intensity of rehabilitative gait training.

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“…Nudo and colleagues demonstrated rewiring from M1 to PMv after ischemic brain injury, with substantial enlargements of the hand representation in the remote PMv that are proportional to the amount of hand representation destroyed in M1 (Frost et al, 2003;Dancause et al, 2005). Nelles et al (2001) pointed out the crucial role of a network including the lower part of BA40 and PMv, bilaterally, in task-oriented passive training aimed at improving motor recovery in severely impaired stroke patients. These areas could also be crucial for promoting reorganization in the rest of the brain.…”

Section: Activation Of Sensorimotor Network By Somatosensory Inputmentioning

confidence: 99%

Activation of Brain Sensorimotor Network by Somatosensory Input in Patients with Hemiparetic Stroke: A Functional MRI Study

Kato¹,

Izumiyama²

2013

Novel Frontiers of Advanced Neuroimaging

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Arm Training Induced Brain Plasticity in Stroke Studied with Serial Positron Emission Tomography

Cited by 233 publications

References 26 publications

Motions or muscles? Some behavioral factors underlying robotic assistance of motor recovery

Motions or muscles? Some behavioral factors underlying robotic assistance of motor recovery

Ankle dorsiflexion as an fMRI paradigm to assay motor control for walking during rehabilitation

Activation of Brain Sensorimotor Network by Somatosensory Input in Patients with Hemiparetic Stroke: A Functional MRI Study

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