Exploratory study of how Cognitive Multisensory Rehabilitation restores parietal operculum connectivity and improves upper limb movements in chronic stroke

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 diff...

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Bibliographic Details
Published in:	Scientific reports Vol. 10; no. 1; p. 20278
Main Authors:	Van de Winckel, A., De Patre, D., Rigoni, M., Fiecas, M., Hendrickson, T. J., Larson, M., Jagadeesan, B. D., Mueller, B. A., Elvendahl, W., Streib, C., Ikramuddin, F., Lim, K. O.
Format:	Journal Article
Language:	English
Published:	London Nature Publishing Group UK 20-11-2020 Nature Publishing Group
Subjects:	692/617/375/534 692/698/1688/64 692/699/375/534 692/700/228/491 Adult Aged Aged, 80 and over Arm Case-Control Studies Chronic Disease - rehabilitation Cognitive ability Cognitive Behavioral Therapy - methods Connectome Feedback, Sensory - physiology Female Follow-Up Studies Healthy Volunteers Hemiplegia Humanities and Social Sciences Humans Magnetic Resonance Imaging Male Middle Aged Movement - physiology multidisciplinary Neural networks Operculum Paresis Parietal Lobe - diagnostic imaging Parietal Lobe - physiology Pilot Projects Recovery of Function - physiology Rehabilitation Rest - physiology Science Science (multidisciplinary) Sensorimotor system Stroke Stroke - physiopathology Stroke Rehabilitation - methods Treatment Outcome Upper Extremity - physiology
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Summary:	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.
Bibliography:	ObjectType-Article-2 SourceType-Scholarly Journals-1 ObjectType-Feature-1 content type line 23
ISSN:	2045-2322 2045-2322
DOI:	10.1038/s41598-020-77272-y