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The plasticity of intrinsic functional connectivity patterns associated with rehabilitation intervention in chronic stroke patients

  • Functional Neuroradiology
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Abstract

Introduction

It has been demonstrated that rehabilitative interventions can promote motor function recovery in stroke patients. However, little is known regarding the neural mechanisms that underlie the rehabilitation treatments. The aim of this study was to investigate the plasticity of intrinsic functional connectivity patterns that are associated with rehabilitation intervention in chronic stroke patients.

Methods

Twelve chronic stroke patients with subcortical lesions in the left motor pathway participated in a 4-week rehabilitation intervention and underwent resting-state functional magnetic resonance imaging (fMRI) scanning before and after the intervention. Both functional connectivity analyses of the ipsilesional (left) primary motor cortex (M1) and measurements of the lateralization index of the connectivity patterns were performed in both the stroke patients and healthy controls (HC).

Results

Compared with the HC, the decreased connectivity of the ipsilesional M1 with the contralesional sensorimotor cortex (SMC), bilateral supplementary motor areas, and inferior parietal lobule due to stroke were remarkably restored after the intervention. More specifically, the lateralization index of the bilateral SMC tends to be the normal level. Moreover, comparing post- with pre-intervention, we observed significantly increased connectivity of ipsilesional M1 with the contralesional M1 and medial superior frontal gyrus (mSFG). Additionally, the index of pre-intervention connectivity with the contralesional mSFG was positively correlated with motor improvement.

Conclusion

The impact of rehabilitation intervention on intrinsic functional connectivity patterns throughout the brain was measurable on resting-state fMRI, and systematic assessment of resting-state functional connectivity can provide prognostic insight for later motor improvement.

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Acknowledgments

This research was supported by the China National Nature Science Foundation (grant no. 81471651), the China National Nature Science Young Foundation (grant no. 81401859), the 12th Five-Year Plan supporting project of Ministry of Science and Technology of the People’s Republic of China (grant no. 2013BAI10B03), the Shanghai Zhabei District Health Bureau (grant no. 2014MS06) and the Shanghai Commission of Healthy and Family Planning (grant no. 201440634). We would like to thank all of the volunteers and stroke patients for their participation in this study.

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    Authors and Affiliations

    1. Shanghai Key Laboratory of Magnetic Resonance, East China Normal University, 3663 North Zhong-Shan Road, 200062, Shanghai, China

      Xiaohui Zheng, Zhiyong Zhao, Yuwei Jiang, Xiangmin Wang, Jie Wu, Jiayu Gong & Mingxia Fan

    2. Institute of Neuroscience, Laboratory of Primate Neurobiology, Shanghai Institute for Biological Sciences, Chinese Academy of Sciences, Shanghai, China

      Dazhi Yin

    3. Department of Rehabilitation, Huashan Hospital, Fudan University, Shanghai, China

      Limin Sun & Jie Jia

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    1. Xiaohui Zheng
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    2. Limin Sun
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    Correspondence to Mingxia Fan.

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    We declare that all human and animal studies have been approved by the Institutional Ethics Committee of East China Normal University, Shanghai, China, and have therefore been performed in accordance with the ethical laid down in the 1964 Declaration of Helsinki and its later amendments. We declare that all patients gave informed consent prior to inclusion in this study.

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    We declare that we have no conflict of interest.

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    XZ and LS are joint first authors and contributed equally to this study.

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    Fig. S1

    Comparison of the functional connectivity of the ipsilesional M1 between stroke patients (at both pre- and post-intervention) and HC. (DOCX 2500 kb)

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    Zheng, X., Sun, L., Yin, D. et al. The plasticity of intrinsic functional connectivity patterns associated with rehabilitation intervention in chronic stroke patients. Neuroradiology 58, 417–427 (2016). https://doi.org/10.1007/s00234-016-1647-4

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