Modulation of interhemispheric activation balance in motor-related areas of stroke patients with motor recovery: Systematic review and meta-analysis of fMRI studies

Tang, Qing; Li, Guangming; Liu, Tao; Wang, Anguo; Feng, Shi Ting; Liao, Xiang; Jin, Yu; Guo, Zhiwei; He, Bin; McClure, Morgan A.; Xing, Guoqiang; Mu, Qiwen

doi:10.1016/j.neubiorev.2015.09.003

Cited by 61 publications

(43 citation statements)

References 62 publications

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“…The expression of the mean ± SE was converted to the mean ± SD based on the principles of the Cochrane Handbook for Systematic Reviews of Interventions [30]. For the graphic, the original means and SDs were extracted with the aided software GetData Graph Digitizer 2.25 (http://getdata-graph-digitizer.com/) [31]. The data syntheses were performed by RevMan 5.3 (Cochrane Collaboration, Oxford, England).…”

Section: Methodsmentioning

confidence: 99%

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The effect and safety of monoclonal antibodies to calcitonin gene-related peptide and its receptor on migraine: a systematic review and meta-analysis

et al. 2017

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BackgroundMigraine has been recognized as one of the leading causes of disability in the 2013 Global Burden of Disease Study and seriously affects the quality of patients’ life, current treatment options are not ideal. Monoclonal antibodies to calcitonin gene-related peptide and its receptor (CGRP-mAbs) appear more promising for migraine because of considerably better effect and safety profiles. The objective of this study is to systematically assess the clinical efficacy and safety of CGRP-mAbs for migraine therapy.MethodsA systematic literature search in PubMed, Cochrane Library and Baidu Scholar was performed to identify randomized controlled trials (RCTs), which compared the effect and safety of CGRP-mAbs with placebo on migraine. Regarding the efficacy, the reduction of monthly migraine days from baseline to weeks 1–4, 5–8, and 9–12; responder rates were extracted as the outcome measures of the effects of CGRP-mAbs. Regarding the safety, total adverse events, the main adverse events, and other adverse events were evaluated.ResultsWe found significant reduction of monthly migraine days in CGRP-mAbs vs. placebo (weeks 1–4: SMD −0.49, 95% CI −0.61 to −0.36; weeks 5–8: SMD −0.43, 95% CI −0.56 to −0.30; weeks 9–12: SMD −0.37, 95% CI −0.49 to −0.24). 50% and 75% responder rates (OR 2.59, 95% CI 1.99 to 3.37; and OR 2.91, 95% CI 2.06 to 4.10) were significantly increased compared with placebo. There was no significant difference in total adverse events (OR 1.17, 95% CI 0.91 to 1.51), and the main adverse events including upper respiratory tract infection (OR 1.44, 95% CI 0.82 to 2.55), nasopharyngitis (OR 0.59, 95% CI 0.30 to 1.16), nausea (OR 0.61, 95% CI 0.29 to 1.32), injection-site pain (OR 1.73, 95% CI 0.95 to 3.16) and back pain (OR 0.97, 95% CI 0.49 to 1.90) were not obviously changed compared with placebo control, but the results showed significant increase of dizziness in CGRP-mAbs vs. placebo (OR 3.22, 95% CI 1.09 to 9.45).ConclusionsThis meta-analysis suggests that CGRP-mAbs are effective in anti-migraine therapy with few adverse reactions, but more and larger sample-size RCTs are required to verify the current findings.

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Section: Methodsmentioning

confidence: 99%

“…Therefore, funnel plots were used to detect publication bias of the meta-analysis. When the funnel plot was approximately symmetrical and a majority of studies were located at its superior part, it was considered that there was no significant publication bias in the meta-analysis [31, 34]. …”

Section: Methodsmentioning

confidence: 99%

The effect and safety of monoclonal antibodies to calcitonin gene-related peptide and its receptor on migraine: a systematic review and meta-analysis

et al. 2017

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“…As an effective means to explore post-stroke brain activity en masse, details of fMRI responses have been considered important and examined to provide clues for understanding functional recovery and related neural mechanisms (Tang et al, 2015; Thiel and Vahdat, 2015). In this regard, both experimental models as well as human patients have been used to investigate whether and how any spatiotemporal deviants in the fMRI activation pattern are associated with neurological and functional recovery and reformation of the damaged brain (Calautti and Baron, 2003; Kim et al, 2005).…”

Section: Discussionmentioning

confidence: 99%

“…For identifying brain regions associated with restorative processes, task/stimulus-induced functional MRI (fMRI) has been frequently used to visualize brain activities associated with the neurologic recovery (for review see references Macey et al, 2015; Tang et al, 2015). More recently, resting state fMRI (rs-fMRI) has also provided a platform to explore spatiotemporal changes in neural connection across a wide range of brain regions.…”

Section: Introductionmentioning

confidence: 99%

Enhanced Thalamic Functional Connectivity with No fMRI Responses to Affected Forelimb Stimulation in Stroke-Recovered Rats

Shim

Suh

Kim

et al. 2017

Front. Neural Circuits

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Neurological recovery after stroke has been extensively investigated to provide better understanding of neurobiological mechanism, therapy, and patient management. Recent advances in neuroimaging techniques, particularly functional MRI (fMRI), have widely contributed to unravel the relationship between the altered neural function and stroke-affected brain areas. As results of previous investigations, the plastic reorganization and/or gradual restoration of the hemodynamic fMRI responses to neural stimuli have been suggested as relevant mechanisms underlying the stroke recovery process. However, divergent study results and modality-dependent outcomes have clouded the proper interpretation of variable fMRI signals. Here, we performed both evoked and resting state fMRI (rs-fMRI) to clarify the link between the fMRI phenotypes and post-stroke functional recovery. The experiments were designed to examine the altered neural activity within the contra-lesional hemisphere and other undamaged brain regions using rat models with large unilateral stroke, which despite the severe injury, exhibited nearly full recovery at ∼6 months after stroke. Surprisingly, both blood oxygenation level-dependent and blood volume-weighted (CBVw) fMRI activities elicited by electrical stimulation of the stroke-affected forelimb were completely absent, failing to reveal the neural origin of the behavioral recovery. In contrast, the functional connectivity maps showed highly robust rs-fMRI activity concentrated in the contra-lesional ventromedial nucleus of thalamus (VM). The negative finding in the stimuli-induced fMRI study using the popular rat middle cerebral artery model denotes weak association between the fMRI hemodynamic responses and neurological improvement. The results strongly caution the indiscreet interpretation of stroke-affected fMRI signals and demonstrate rs-fMRI as a complementary tool for efficiently characterizing stroke recovery.

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“…Motor deficit is the most common symptom in stroke, and motor recovery has been associated with functional reorganization of the motor network (Duncan et al, 2000). All previous studies on the reorganization of the SMA after stroke have treated the SMA as a whole and reported increased activation in the SMA (Tombari et al, 2004;Jaillard et al, 2005;Tang et al, 2015;Chen et al, 2018) and increased effective connectivity of the SMA in chronic stroke patients when they perform motor or motor imagery tasks (Mintzopoulos et al, 2009;Sharma et al, 2009;Rehme et al, 2011). However, the rsFC alterations of the SMA after stroke have never been studied at the level of the subregion.…”

Section: Introductionmentioning

confidence: 99%

Differential Reorganization of SMA Subregions After Stroke: A Subregional Level Resting-State Functional Connectivity Study

Liu

Cai

et al. 2020

Front. Hum. Neurosci.

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Background and Purpose: The human supplementary motor area (SMA) contains two functional subregions of the SMA proper and preSMA; however, the reorganization patterns of the two SMA subregions after stroke remain uncertain. Meanwhile, a focal subcortical lesion may affect the overall functional reorganization of brain networks. We sought to identify the differential reorganization of the SMA subregions after subcortical stroke using the resting-state functional connectivity (rsFC) analysis. Methods: Resting-state functional MRI was conducted in 25 patients with chronic capsular stroke exhibiting well-recovered global motor function (Fugl-Meyer score >90). The SMA proper and preSMA were identified by the rsFC-based parcellation, and the rsFCs of each SMA subregion were compared between stroke patients and healthy controls. Results: Despite common rsFC with the fronto-insular cortex (FIC), the SMA proper and preSMA were mainly correlated with the sensorimotor areas and cognitiverelated regions, respectively. In stroke patients, the SMA proper and preSMA exhibited completely different functional reorganization patterns: the former showed increased rsFCs with the primary sensorimotor area and caudal cingulate motor area (CMA) of the motor execution network, whereas the latter showed increased rsFC with the rostral CMA of the motor control network. Both of the two SMA subregions showed decreased rsFC with the FIC in stroke patients; the preSMA additionally showed decreased rsFC with the prefrontal cortex (PFC). Conclusion: Although both SMA subregions exhibit functional disconnection with the cognitive-related areas, the SMA proper is implicated in the functional reorganization within the motor execution network, whereas the preSMA is involved in the functional reorganization within the motor control network in stroke patients.

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Modulation of interhemispheric activation balance in motor-related areas of stroke patients with motor recovery: Systematic review and meta-analysis of fMRI studies

Cited by 61 publications

References 62 publications

The effect and safety of monoclonal antibodies to calcitonin gene-related peptide and its receptor on migraine: a systematic review and meta-analysis

The effect and safety of monoclonal antibodies to calcitonin gene-related peptide and its receptor on migraine: a systematic review and meta-analysis

Enhanced Thalamic Functional Connectivity with No fMRI Responses to Affected Forelimb Stimulation in Stroke-Recovered Rats

Differential Reorganization of SMA Subregions After Stroke: A Subregional Level Resting-State Functional Connectivity Study

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