Neuroscience 2004 Abstract
| Presentation Number: | 431.7 |
|---|---|
| Abstract Title: | The effect of constraint-induced therapy for stroke on functional MRI motor maps. |
| Authors: |
Greenberg, J. P.*1
; Butler, A. J.2
; Sawaki, L.1
; Schmalbrock, P.
; Mao, H.3
; Nichols, D. S.4
; Wolf, S. L.2
; Wittenberg, G. F.1
; Good, D. C.1
1Neurol., Program in Rehab., Wake Forest Univ. SM, Winston-Salem, NC 2GA, Medical Center Blvd., 27157-1078, 3USA, Medical Center Blvd., 27157-1078, 4Rehab. Med., Medical Center Blvd., 27157-1078, |
| Primary Theme and Topics |
Neurological and Psychiatric Conditions - Brain Blood Flow, Metabolism, and Homeostasis -- Functional Imaging |
| Session: |
431. Functional Imaging Poster |
| Presentation Time: | Monday, October 25, 2004 10:00 AM-11:00 AM |
| Location: | San Diego Convention Center - Hall A-H, Board # II27 |
| Keywords: | REHABILITATION, PLASTICITY, BRAIN IMAGING, CEREBRAL CORTEX |
We recently reported preliminary data suggesting Constraint Induced Therapy (CIT), a promising intervention to enhance motor recovery from stroke, may be associated with increases in motor cortical projections to the weak finger muscles as measured by transcranial magnetic stimulation (TMS; 1). Here we report the results of parallel functional MRI (fMR) studies.
METHODS: As part of an ongoing multicenter project, hemiparetic patients received CIT within one year of their stroke. fMR was performed prior to CIT (baseline), 2 weeks later, and at 4 months. During fMR patients repeatedly extended/flexed their paretic fingers at 70% maximal rate for 30 second blocks alternating with rest. fMR maps were generated with SPM99.
RESULTS: One chronic and four subacute patients are included. There was considerable variability between patients. In many, both hemispheres showed increased activation at 2 weeks compared to baseline, more on the side of the stroke. These changes persisted or increased at 4 months. Fugl-Meyer scores also improved over time in all patients.
CONCLUSIONS: These observations suggest that the clinical improvement associated with two weeks of CIT in these patients was also generally associated with an increase in contralateral cortical motor representation of extension-flexion movement of the weak fingers. These cortical changes usually persisted over 4 months. We anticipate extending our observations once a larger number of patients are enrolled.
Reference: 1. Sawaki L, et al. Motor Map Plasticity in Constraint Therapy for Stroke . Stroke. 2004 Jan;35(1): 284-5.
METHODS: As part of an ongoing multicenter project, hemiparetic patients received CIT within one year of their stroke. fMR was performed prior to CIT (baseline), 2 weeks later, and at 4 months. During fMR patients repeatedly extended/flexed their paretic fingers at 70% maximal rate for 30 second blocks alternating with rest. fMR maps were generated with SPM99.
RESULTS: One chronic and four subacute patients are included. There was considerable variability between patients. In many, both hemispheres showed increased activation at 2 weeks compared to baseline, more on the side of the stroke. These changes persisted or increased at 4 months. Fugl-Meyer scores also improved over time in all patients.
CONCLUSIONS: These observations suggest that the clinical improvement associated with two weeks of CIT in these patients was also generally associated with an increase in contralateral cortical motor representation of extension-flexion movement of the weak fingers. These cortical changes usually persisted over 4 months. We anticipate extending our observations once a larger number of patients are enrolled.
Reference: 1. Sawaki L, et al. Motor Map Plasticity in Constraint Therapy for Stroke . Stroke. 2004 Jan;35(1): 284-5.
Supported by NICHD 1 RO1 HD-40984-01A1
Sample Citation:
[Authors]. [Abstract Title]. Program No. XXX.XX. 2004 Neuroscience Meeting Planner. San Diego, CA: Society for Neuroscience, 2004. Online.
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