Cognitive Multisensory Rehabilitation (CMR) is a promising therapy for upper limb recovery in stroke, but the brain mechanisms are unknown. We previously demonstrated that the parietal operculum (parts OP1/OP4) is activated with CMR exercises. In this exploratory study, we assessed the baseline difference between OP1/OP4 functional connectivity (FC) at rest in stroke versus healthy adults to then explore whether CMR affects OP1/OP4 connectivity and sensorimotor recovery after stroke. We recruited 8 adults with chronic stroke and left hemiplegia/paresis and 22 healthy adults. Resting-state FC with the OP1/OP4 region-of-interest in the affected hemisphere was analysed before and after 6 weeks of CMR. We evaluated sensorimotor function and activities of daily life pre- and post-CMR, and at 1-year post-CMR. At baseline, we found decreased FC between the right OP1/OP4 and 34 areas distributed across all lobes in stroke versus healthy adults. After CMR, only four areas had decreased FC compared to healthy adults. Compared to baseline (pre-CMR), participants improved on motor function (MESUPES arm p = 0.02; MESUPES hand p = 0.03; MESUPES total score p = 0.006); on stereognosis (p = 0.03); and on the Frenchay Activities Index (p = 0.03) at post-CMR and at 1-year follow-up. These results suggest enhanced sensorimotor recovery post-stroke after CMR. Our results justify larger-scale studies.
Bibliographical noteFunding Information:
We would like to thank Wei Deng for her assistance with the box plots and Dr. Yuichiro Takagi for the critical reading of the manuscript. This work was supported by the OVPR Grant-in-Aid of Research, Artistry, and Scholarship program University of Minnesota (#110760), The National Institutes of Health (NIH) P41 EB015894, P30 NS076408 “Institutional Centre Cores for Advanced Neuroimaging”, 1S10OD017974-01 "High Performance Connectome Upgrade for Human 3T MR Scanner", and the National Centre for Advancing Translational Sciences of the National Institutes of Health Award Number UL1-TR002494. The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health. None of the funding agencies played a role in the design, execution, analysis, data interpretation or writing of the manuscript.
© 2020, The Author(s).
PubMed: MeSH publication types
- Clinical Trial
- Journal Article
- Research Support, N.I.H., Extramural
- Research Support, Non-U.S. Gov't