Simultaneous recording of brain activations and movement kinematics subacute post-stroke: Understanding neuromotor control to optimize recovery - 15/07/18
, E. Le Bars 2, 3, D. Mottet 4, J. Froger 5, A. Bonafe 3, N. Menjot de Champfleur 2, 3, I. Laffont 1, 4
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Résumé |
Introduction/Background |
Rehabilitation, aiming to stimulate underlying neural plasticity, takes an important place in patients’ treatment post-stroke. Here we confront fine-grained movement kinematics with corresponding brain activations to reveal recovery markers usable to individualize therapeutic approaches favoring plasticity and maximizing recovery.
Material and method |
Twenty-one participants early post-stroke with initial severe motor deficits were compared with 13 controls. Participants were evaluated twice,<8 weeks post-stroke and after 6 weeks of rehabilitation. Kinematic data were collected during movement execution within the fMRI. The movement consisted of a continuous elbow flexion/extension. Calculated kinematics captured the movements’ shaping (amplitude, frequency) and the structure (fluency, directness, and the variability's entropy).
Results |
People post-stroke generally moved with decreased amplitude, smoothness, directness and entropy compared to controls. The frequency was lower for the paretic upper limb and during bilateral movements, but comparable to controls during ipsilesional upper limb movement. The variability's entropy was in both controls and patients related to increased activations in the middle frontal lobe, presumably indicating more feed forward based control. In patients, the amplitude and smoothness were correlated with strong implication of the occipital lobe, and additional recruitment of the rolandic opercularis (visualization) was observed during both paretic and ipsilesional movement, related to motor learning. Patients’ kinematic characteristics were unrelated to clinical scores and lesion characteristics, supporting the idea that they reflect motor control strategies.
Conclusion |
The co-registration of fine-grained kinematics and fMRI measures revealed how different kinematic profiles are related to different motor control organizations. Analyzing kinematics in a standardized manner might contribute to the implementation of a personalized rehabilitation strategy, and more targeted brain stimulation protocols to stimulate plasticity and optimize recovery.
Le texte complet de cet article est disponible en PDF.Keywords : Stroke, Brain imaging, Movement kinematics
Plan
Vol 61 - N° S
P. e177 - juillet 2018 Retour au numéro
Article précédent
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