Functional network connectivity is altered in patients with upper limb somatosensory impairments in the acute phase post stroke: A cross-sectional study

Bruyn, Nele De; Meyer, Sarah; Kessner, Simon S; Essers, Bea; Cheng, Bastian; Thomalla, Götz; Peeters, André; Sunaert, Stefan; Duprez, Thierry; Thijs, Vincent; Feys, Hilde; Alaerts, Kaat; Verheyden, Geert

doi:10.1371/journal.pone.0205693

Cited by 19 publications

(14 citation statements)

References 63 publications

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“…However, these studies have not discussed the classification of the time course of recovery from a stroke or the recovery stages of sensory-motor function. In the acute phase after stroke, the interand intra-hemispheric rsFC differ depending on the severity of the stroke and become weak in patients with severe conditions (De Bruyn et al, 2018). In patients in the subacute-to-chronic phase after stroke, the rsFC between M1 of each hemisphere decreases compared with that in healthy control individuals (Zhang et al, 2016).…”

Section: Introductionmentioning

confidence: 99%

A Case Series Clinical Trial of a Novel Approach Using Augmented Reality That Inspires Self-body Cognition in Patients With Stroke: Effects on Motor Function and Resting-State Brain Functional Connectivity

Kaneko

Shindo

Yoneta

et al. 2019

Front. Syst. Neurosci.

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Barring a few studies, there are not enough established treatments to improve upper limb motor function in patients with severe impairments due to chronic stroke. This study aimed to clarify the effect of the kinesthetic perceptional illusion induced by visual stimulation (KINVIS) on upper limb motor function and the relationship between motor function and resting-state brain networks. Eleven patients with severe paralysis of upper limb motor function in the chronic phase (seven men and four women; age: 54.7 ± 10.8 years; 44.0 ± 29.0 months post-stroke) participated in the study. Patients underwent an intervention consisting of therapy using KINVIS and conventional therapeutic exercise (TherEX) for 10 days. Our originally developed KiNvis TM system was applied to induce KINVIS while watching the movement of the artificial hand. Clinical outcomes were examined to evaluate motor functions and resting-state brain functional connectivity (rsFC) by analyzing blood-oxygen-level-dependent (BOLD) signals measured using functional magnetic resonance imaging (fMRI). The outcomes of motor function (Fugle-Meyer Assessment, FMA) and spasticity (Modified Ashworth Scale, MAS) significantly improved after the intervention. The improvement in MAS scores for the fingers and the wrist flexors reached a minimum of clinically important differences. Before the intervention, strong and significant negative correlations between the motor functions

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Section: Introductionmentioning

confidence: 99%

A Case Series Clinical Trial of a Novel Approach Using Augmented Reality That Inspires Self-body Cognition in Patients With Stroke: Effects on Motor Function and Resting-State Brain Functional Connectivity

Kaneko

Shindo

Yoneta

et al. 2019

Front. Syst. Neurosci.

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“… 7 In a study of 19 acute stroke patients, lower interhemispheric and ipsilesional intrahemispheric functional connectivity within the somatosensory network has been identified in the subgroup of patients displaying more severe compared with mild to moderate somatosensory impairments in the upper limb. 8 Furthermore, in a longitudinal study from 1 to 6 months post stroke, improvement in touch sensation due to spontaneous recovery was shown to be associated with increased connectivity between inferior parietal cortex and middle temporal gyrus with contralesional secondary somatosensory cortex (S2), and between contralesional thalamus and cerebellum. 9 Next to normalization of functional connectivity related to severity of impairment or to natural recovery, also changes related to therapy-induced improvements are reported in literature.…”

Section: Introductionmentioning

confidence: 99%

Brain connectivity alterations after additional sensorimotor or motor therapy for the upper limb in the early-phase post stroke: a randomized controlled trial

Bruyn

Saenen

Thijs

et al. 2021

Brain Communications

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Somatosensory function plays an important role for upper limb motor learning. However, knowledge about underlying mechanisms of sensorimotor therapy is lacking. We aim to investigate differences in therapy-induced resting state functional connectivity changes between additional sensorimotor compared to motor therapy in the early phase post stroke. Thirty first-stroke patients with a sensorimotor impairment were included for an assessor-blinded multi-centre randomized controlled trial within eight weeks post stroke (13 (43%) females; mean age: 67 ± 13 years; mean time post stroke: 43 ± 13 days). Patients were randomly assigned to additional sensorimotor (n = 18) or motor (n = 12) therapy, receiving 16 hours of additional therapy within 4 weeks. Sensorimotor evaluations and resting state functional magnetic resonance imaging (fMRI) were performed at baseline (T1), post-intervention (T2) and after four weeks follow-up (T3). Resting-state fMRI was also performed in an age-matched healthy control group (n = 19) to identify patterns of aberrant connectivity in stroke patients between hemispheres, or within ipsilesional and contralesional hemispheres. Mixed model analysis investigated session and treatment effects between stroke therapy groups. Non-parametric partial correlations were used to investigate brain-behaviour associations with age and frame wise displacement as nuisance regressors. Connections within the contralesional hemisphere that showed hypo-connectivity in subacute stroke patients (compared to healthy controls) showed a trend towards a more pronounced pre-to-post normalization (less hypo-connectivity) in the motor therapy group, compared to the sensorimotor therapy group (mean estimated difference= -0.155 ± 0.061; p = 0.02). Further, the motor therapy group also tended to show a further pre-to-post increase in functional connectivity strength among connections that already showed hyper-connectivity in the stroke patients at baseline versus healthy controls (mean estimated difference= -0.144 ± 0.072; p = 0.06). Notably, these observed increases in hyper-connectivity of the contralesional hemisphere were positively associated with improvements in functional activity (r = 0.48), providing indications that these patterns of hyper-connectivity are compensatory in nature. The sensorimotor and motor therapy group showed no significant differences in terms of pre-to-post changes in inter-hemispheric connectivity or ipsilesional intrahemispheric connectivity. While effects are only tentative within this preliminary sample, results suggest a possible stronger normalisation of hypo-connectivity and a stronger pre-to-post increase in compensatory hyper-connectivity of the contralesional hemisphere after motor therapy compared to sensorimotor therapy. Future studies with larger patient samples are however recommended to confirm these trend-based preliminary findings.

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“…9,13 To date, changes in rsFC have largely characterized functional reorganization that occurs in association with recovery from stroke. 11,12,14,15 It remains unclear whether or not skilled motor practice drives changes in rsFC patterns.…”

Section: Introductionmentioning

confidence: 99%

Resting State Connectivity Is Modulated by Motor Learning in Individuals After Stroke

Kraeutner

Rubino

Rinat

et al. 2021

Neurorehabil Neural Repair

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Objective Activity patterns across brain regions that can be characterized at rest (ie, resting-state functional connectivity [rsFC]) are disrupted after stroke and linked to impairments in motor function. While changes in rsFC are associated with motor recovery, it is not clear how rsFC is modulated by skilled motor practice used to promote recovery. The current study examined how rsFC is modulated by skilled motor practice after stroke and how changes in rsFC are linked to motor learning. Methods Two groups of participants (individuals with stroke and age-matched controls) engaged in 4 weeks of skilled motor practice of a complex, gamified reaching task. Clinical assessments of motor function and impairment, and brain activity (via functional magnetic resonance imaging) were obtained before and after training. Results While no differences in rsFC were observed in the control group, increased connectivity was observed in the sensorimotor network, linked to learning in the stroke group. Relative to healthy controls, a decrease in network efficiency was observed in the stroke group following training. Conclusions Findings indicate that rsFC patterns related to learning observed after stroke reflect a shift toward a compensatory network configuration characterized by decreased network efficiency.

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Functional network connectivity is altered in patients with upper limb somatosensory impairments in the acute phase post stroke: A cross-sectional study

Cited by 19 publications

References 63 publications

A Case Series Clinical Trial of a Novel Approach Using Augmented Reality That Inspires Self-body Cognition in Patients With Stroke: Effects on Motor Function and Resting-State Brain Functional Connectivity

A Case Series Clinical Trial of a Novel Approach Using Augmented Reality That Inspires Self-body Cognition in Patients With Stroke: Effects on Motor Function and Resting-State Brain Functional Connectivity

Brain connectivity alterations after additional sensorimotor or motor therapy for the upper limb in the early-phase post stroke: a randomized controlled trial

Resting State Connectivity Is Modulated by Motor Learning in Individuals After Stroke

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