Mean diffusivity as a potential diffusion tensor biomarker of motor rehabilitation after electrical stimulation incorporating task specific exercise in stroke: a pilot study.
Changes in diffusion tensor imaging (DTI) values co-occur with neurological and functional changes after stroke. However, quantitative DTI metrics have not been examined in response to participation in targeted rehabilitative interventions in chronic stroke. The primary purpose of this pilot study w...
| Publicado en: | Brain Imaging & Behavior Vol. 8; no. 3; pp. 359 - 370 |
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| Autores principales: | , , , , , |
| Formato: | clinical trial research Journal Article |
| Publicado: |
Springer Nature
Sep2014
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| Acceso en línea: | Ver este registro en EBSCOhost |
| fields | @attributes: recordID: 1 pdfLink: plink: https://search.ebscohost.com/login.aspx?direct=true&db=ccm&AN=103847061&site=ehost-live header: @attributes: shortDbName: ccm uiTerm: 103847061 longDbName: CINAHL Complete uiTag: AN controlInfo: bkinfo: dissinfo: jinfo: jid: 19317557 3GSC jtl: Brain Imaging & Behavior issn: 19317557 maglogo: N pubinfo: dt: Sep2014 vid: 8 iid: 3 pid: 237 pub: Springer Nature place: New York, New York artinfo: ui: 103847061 NLM22203524 2012741175 10.1007/s11682-011-9144-1 NLM22203524 103847061 ppf: 359 ppct: 11 formats: fmt: @attributes: type: P tig: atl: Mean diffusivity as a potential diffusion tensor biomarker of motor rehabilitation after electrical stimulation incorporating task specific exercise in stroke: a pilot study. aug: au: Boespflug, Erin L Storrs, Judd M Allendorfer, Jane B Lamy, Martine Eliassen, James C Page, Stephen affil: Psychiatry and Behavioral Neurosciences & Center for Imaging Research & Neuroscience Graduate Program, University of Cincinnati College of Medicine, 231 Albert Sabin Way, Suite E685, Cincinnati, OH, 45267-0583, USA, boespfel@mail.uc.edu. sug: subj: Brain Pathology Electrotherapy Methods Magnetic Resonance Imaging Methods Manual Therapy Methods Stroke Pathology Stroke Rehabilitation Aged Clinical Assessment Tools Clinical Trials Female Hemiplegia Etiology Hemiplegia Pathology Hemiplegia Rehabilitation Human Image Processing, Computer Assisted Male Middle Age Pilot Studies Prospective Studies Severity of Illness Indices Stroke Complications Treatment Outcomes Upper Extremity Aged: 65+ years Middle Aged: 45-64 years Female Male ab: Changes in diffusion tensor imaging (DTI) values co-occur with neurological and functional changes after stroke. However, quantitative DTI metrics have not been examined in response to participation in targeted rehabilitative interventions in chronic stroke. The primary purpose of this pilot study was to examine whether changes in DTI metrics co-occur with paretic arm movement changes among chronic stroke patients participating in a regimen of electrical stimulation targeting the paretic arm. Three subjects exhibiting stable arm hemiparesis were administered 30-minute (n = 1) or 120-minute (n = 2) therapy sessions emphasizing paretic arm use during valued, functional tasks and incorporating an electrical stimulation device. These sessions occurred every weekday for 8 weeks. A fourth subject served as a treatment control, participating in a 30-minute home exercise regimen without electrical stimulation every weekday for 8 weeks. DTI and behavioral outcome measures were acquired at baseline and after intervention. DTI data were analyzed using a region of interest (ROI) approach, with ROIs chosen based on tract involvement in sensorimotor function or as control regions. Behavioral outcome measures were the Fugl-Meyer Scale (FM) and the Action Research Arm Test (ARAT). The treatment control subject exhibited gains in pinch and grasp, as shown by a 5-point increase on the ARAT. The subject who participated in 30-minute therapy sessions exhibited no behavioral gains. Subjects participating in 120-minute therapy sessions displayed consistent impairment reductions and distal movement changes. DTI changes were largest in subjects two and three, with mean diffusivity (MD) decreases in the middle cerebellar peduncle and posterior limb of the internal capsule following treatment. No changes in fractional anisotropy (FA) were observed for sensorimotor tracts. Our preliminary results suggest that active rehabilitative therapies augmented by electrical stimulation may induce positive behavioral changes which are underscored by DTI changes indicative of increased white matter tract integrity in regions specific to sensory-motor function. pubtype: Academic Journal doctype: clinical trial research Journal Article ougenre: Article language: English refInfo: holdings: @attributes: islocal: N |
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