Lateralization in the hand motor cortex during rehabilitation after acute cerebral infarction / 中华物理医学与康复杂志

ABSTRACT

Objective To observe any change in the laterality index (LI) in the active volume of the hand motor cortex during rehabilitation after acute cerebral infarction and to analyze the mechanisms involved in the rehabilitation of motor function.Methods Sixteen patients with acute cerebral infarcts were administered standard but individualized rehabilitation training.Blood oxygenation-dependent functional magnetic resonance imaging (BOLD-fMRI) was used to evaluate the active volume of their hand sensorimotor cortex (SMC) and the LI,at admission and after 14 days of rehabilitation.The Fugl-Meyer motor assessment for the hand (FMA) was used to evaluate hand function.Ten healthy volunteers were recruited as a control group and subjected to a single BOLD-fMRI examination to confirm the location and the volume of the active area when performing the same rehabilitation exercises.Results The baseline LI of affected hand SMC activation was significantly smaller than that of the unaffected hand [(0.010 ±0.808) versus (0.789 ± 0.157)],but no significant difference was observed between the affected and the unaffected hands after treatment.Rehabilitation therapy significantly increased the SMC LI of affected hand activation when compared with the baseline,but no such effect was observed with the unaffected hand.In 12 patients with dysfunction of the right hand as evaluated by the FMA,the baseline LI of the affected hand was smaller than that of the unaffected hand and that of the healthy volunteers.Conclusion Rehabilitation after acute infarction can promote functional recovery.The LI of the affected hand reflects cerebral plasticity during rehabilitation after acute cerebral infarction.