Functional Brain Correlates of Upper Limb Spasticity and Its Mitigation following Rehabilitation in Chronic Stroke Survivors
Background. Arm spasticity is a challenge in the care of chronic stroke survivors with motor deficits. In order to advance spasticity treatments, a better understanding of the mechanism of spasticity-related neuroplasticity is needed. Objective. To investigate brain function correlates of spasticity...
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| Format: | Article |
| Language: | English |
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Wiley
2014-01-01
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| Series: | Stroke Research and Treatment |
| Online Access: | http://dx.doi.org/10.1155/2014/306325 |
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| _version_ | 1832560720508616704 |
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| author | Svetlana Pundik Adam D. Falchook Jessica McCabe Krisanne Litinas Janis J. Daly |
| author_facet | Svetlana Pundik Adam D. Falchook Jessica McCabe Krisanne Litinas Janis J. Daly |
| author_sort | Svetlana Pundik |
| collection | DOAJ |
| description | Background. Arm spasticity is a challenge in the care of chronic stroke survivors with motor deficits. In order to advance spasticity treatments, a better understanding of the mechanism of spasticity-related neuroplasticity is needed. Objective. To investigate brain function correlates of spasticity in chronic stroke and to identify specific regional functional brain changes related to rehabilitation-induced mitigation of spasticity. Methods. 23 stroke survivors (>6 months) were treated with an arm motor learning and spasticity therapy (5 d/wk for 12 weeks). Outcome measures included Modified Ashworth scale, sensory tests, and functional magnetic resonance imaging (fMRI) for wrist and hand movement. Results. First, at baseline, greater spasticity correlated with poorer motor function (P=0.001) and greater sensory deficits (P=0.003). Second, rehabilitation produced improvement in upper limb spasticity and motor function (P<0.0001). Third, at baseline, greater spasticity correlated with higher fMRI activation in the ipsilesional thalamus (rho=0.49, P=0.03). Fourth, following rehabilitation, greater mitigation of spasticity correlated with enhanced fMRI activation in the contralesional primary motor (r=-0.755, P=0.003), premotor (r=−0.565, P=0.04), primary sensory (r=−0.614, P=0.03), and associative sensory (r=−0.597, P=0.03) regions while controlling for changes in motor function. Conclusions. Contralesional motor regions may contribute to restoring control of muscle tone in chronic stroke. |
| format | Article |
| id | doaj-art-26141f16111d4a3eac29b70bc7dcc82e |
| institution | Kabale University |
| issn | 2090-8105 2042-0056 |
| language | English |
| publishDate | 2014-01-01 |
| publisher | Wiley |
| record_format | Article |
| series | Stroke Research and Treatment |
| spelling | doaj-art-26141f16111d4a3eac29b70bc7dcc82e2025-02-03T01:26:52ZengWileyStroke Research and Treatment2090-81052042-00562014-01-01201410.1155/2014/306325306325Functional Brain Correlates of Upper Limb Spasticity and Its Mitigation following Rehabilitation in Chronic Stroke SurvivorsSvetlana Pundik0Adam D. Falchook1Jessica McCabe2Krisanne Litinas3Janis J. Daly4Neurology and Research Service, Cleveland VA Medical Center, 10701 East Boulevard, Cleveland, OH 44106, USADepartment of Neurology and McKnight Brain Institute, Brain Rehabilitation Research Center of Excellence, Malcom Randall VA Medical Center, University of Florida, 1601 SW Archer Road, Gainesville, FL 32608, USANeurology and Research Service, Cleveland VA Medical Center, 10701 East Boulevard, Cleveland, OH 44106, USANeurology and Research Service, Cleveland VA Medical Center, 10701 East Boulevard, Cleveland, OH 44106, USADepartment of Neurology and McKnight Brain Institute, Brain Rehabilitation Research Center of Excellence, Malcom Randall VA Medical Center, University of Florida, 1601 SW Archer Road, Gainesville, FL 32608, USABackground. Arm spasticity is a challenge in the care of chronic stroke survivors with motor deficits. In order to advance spasticity treatments, a better understanding of the mechanism of spasticity-related neuroplasticity is needed. Objective. To investigate brain function correlates of spasticity in chronic stroke and to identify specific regional functional brain changes related to rehabilitation-induced mitigation of spasticity. Methods. 23 stroke survivors (>6 months) were treated with an arm motor learning and spasticity therapy (5 d/wk for 12 weeks). Outcome measures included Modified Ashworth scale, sensory tests, and functional magnetic resonance imaging (fMRI) for wrist and hand movement. Results. First, at baseline, greater spasticity correlated with poorer motor function (P=0.001) and greater sensory deficits (P=0.003). Second, rehabilitation produced improvement in upper limb spasticity and motor function (P<0.0001). Third, at baseline, greater spasticity correlated with higher fMRI activation in the ipsilesional thalamus (rho=0.49, P=0.03). Fourth, following rehabilitation, greater mitigation of spasticity correlated with enhanced fMRI activation in the contralesional primary motor (r=-0.755, P=0.003), premotor (r=−0.565, P=0.04), primary sensory (r=−0.614, P=0.03), and associative sensory (r=−0.597, P=0.03) regions while controlling for changes in motor function. Conclusions. Contralesional motor regions may contribute to restoring control of muscle tone in chronic stroke.http://dx.doi.org/10.1155/2014/306325 |
| spellingShingle | Svetlana Pundik Adam D. Falchook Jessica McCabe Krisanne Litinas Janis J. Daly Functional Brain Correlates of Upper Limb Spasticity and Its Mitigation following Rehabilitation in Chronic Stroke Survivors Stroke Research and Treatment |
| title | Functional Brain Correlates of Upper Limb Spasticity and Its Mitigation following Rehabilitation in Chronic Stroke Survivors |
| title_full | Functional Brain Correlates of Upper Limb Spasticity and Its Mitigation following Rehabilitation in Chronic Stroke Survivors |
| title_fullStr | Functional Brain Correlates of Upper Limb Spasticity and Its Mitigation following Rehabilitation in Chronic Stroke Survivors |
| title_full_unstemmed | Functional Brain Correlates of Upper Limb Spasticity and Its Mitigation following Rehabilitation in Chronic Stroke Survivors |
| title_short | Functional Brain Correlates of Upper Limb Spasticity and Its Mitigation following Rehabilitation in Chronic Stroke Survivors |
| title_sort | functional brain correlates of upper limb spasticity and its mitigation following rehabilitation in chronic stroke survivors |
| url | http://dx.doi.org/10.1155/2014/306325 |
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