Differences of Structural Plasticity between Hemispheres during Rehabilitation for Subacute Stroke / 中国康复理论与实践

Objective:To explore the differences in plasticity mechanism of cortical structure between hemispheres during rehabilitation for stroke patients at subacute stage. Methods:From October 20, 2018 to February 1, 2020, 22 patients with first-onset subcortical ischemic stroke completed the assessments of MRI and clinical evaluation at admission, and after one and two months of rehabilitation. Cortical surface area, thickness, and volume were measured to evaluate cortical structure plasticity. Two-way repeated measures analyses of variance were implemented to estimate dynamic cortical morphology changes and differences between hemispheres. Results:A significant time effect occurred between admission and after one month of rehabilitation for both hemispheres. Cortical surface area, thickness and volume for most regions in both hemispheres gradually decreased, while parahippocampal gyrus thickness and volume increased. The surface area and volume of postcentral gyrus was significant between both hemispheres (F > 4.305, P < 0.05), in which ipsilesional hemisphere was lower than contralesional hemisphere. The reduction of the thickness (r = -0.474, P = 0.026) and volume (r = -0.432, P = 0.044) of postcentral gyrus in ipsilesional hemisphere was negatively correlated with the recovery rate of motor function. Conclusion:There are differences in cortical structure plasticity during stroke rehabilitation between hemispheres. Cortical morphology markedly changes in the first two months poststroke. The greater the reduction in thickness and volume of postcentral gyrus in ipsilesional hemisphere is, the worse the recovery of motor function may be.

Advance in Magnetic Resonance Imaging Research of Rehabilitation Therapy on Cerebral Network Remodeling of Motor Deficits after Stroke (review) / 中国康复理论与实践

With the development of rehabilitation researches for post-stroke motor dysfunction, functional magnetic resonance imaging (fMRI) on nerve injury has also attracted extensive attention. Subcortical lesions of stroke affect nearby or distal brain areas, leading to motor dysfunction. Mirror neuron system therapy, repetitive transcranial magnetic stimulation and transcranial electrical stimulation can activate relevant regions of cerebral cortex in a non-invasive way, and restore the balance between cerebral hemispheres, which can regulate the whole brain network circuit. However, there is a lack of grade A evidence for the effects of transcranial electrical stimulation. Although acupuncture and moxibustion can widely regulate the topological structure of the whole brain functional network nodes, it cannot fully explain the therapeutic mechanism of acupuncture and moxibustion due to the differences of acupuncture point selection, manipulation, time, and channels. The interactive application of rehabilitation therapy and neuroimaging is becoming a new direction of stroke treatment research.