[Changes in the Functional Connectivity of Motor Zones in the Use of Multimodal Exoskeleton Complex "Regent" in the Neurorehabilitation of Post-Stroke Patients].

The article discusses the effect of a course of treatment with the use of multimodal complex exoskeleton (MCE) "Regent" on the reorganization of cortical locomotor zones in 14 patients with post-stroke hemiparesis, mainly atthe chronic stage of the disease. Before the course of treatment, we identified specific areas of activation in the primary sensorimotor and supplementary motor areas and the inferior parietal lobules in both affected and healthy hemispheres by means of functional MRI (fMRI) with the use of special passive sensorimotor paradigms. After the course of treatment with MCE, we observed an improvement of temporal characteristics of walking; it was accompanied by a decrease in the activation zones of inferior parietal lobules, especially in the healthy hemisphere, and by a significant increase in the activation zone of primary sensorimotor and supplementary motor areas. The analysis of the functional connectivity of studied zones before and after the course of treatment with MCE showed significant changes in intra- and interhemispheric interactions.

[Evaluation of changes in the cortical gait control in post-stroke patients induced by the use of the "Regent" soft exoskeleton complex (SEC) by navigated transcranial magnetic stimulation].

The mechanisms underlying the locomotion recovery in poststroke patients remain unknown. Navigated transcranial magnetic stimulation (nTMS) is a new method to evaluate the functional state of the motor system. Using of the exoskeleton complex (EC) allow to correct walking pattern significantly. The aim of this study was to evaluate the capability of nTMS to assess changes in gait cortical control using EC in poststroke patients. 14 patients suffered subcortical stroke, mean age was 53.0 years [49, 62], mean duration of a stroke of 14.2 [7.0; 23.0] months were included. All patients trained with EC for 10 times and also received standardized physical therapy. All patients underwent nTMS, as well as clinical assessment using a Fugl-Meyer Scale lower extremity section and 10 m walking test before and after trains. A significant decrease of time to walk 10 meter was observed, while Fugl-Meyer Score remained unchanged. Patients showed the significant reduction of the average latency of motor responses from the affected hemisphere and different patterns of size and localization changes in both legs' cortical motor areas. Navigates TMS may demonstrate individual patterns of changes in cortical representation of leg muscles in post-stroke patients with damage of various motor system elements, while using exoskeleton complex. Thus, navigated TMS may be used not only for verification of neuroplasticity process, but it may also provide its detailed description.