Correlation of Motor-Task Related Brain Activation Changes With Motor Performance Changes Induced by Constraint-Induced Therapy After Stroke.

Background: Steven Wolf made an exceptional effort to design, organize, and conduct a study of the biology of constraint induced movement therapy (CIMT) but only the transcranial magnetic stimulation results have been published previously. Objective: To evaluate changes in motor-task related brain a...

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Published in:Neurorehabilitation & Neural Repair Vol. 40; no. 9; pp. 807 - 815
Main Authors: Wittenberg, George F., Leng, Xiaoyan, Butler, Andrew J., Sathian, Krishnankutty
Format: diagnostic images research tables/charts Journal Article
Published: Sage Publications Inc. Sep2026
Online Access:View this record in EBSCOhost
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      dt: Sep2026
      vid: 40
      iid: 9
      pid: 344
      pub: Sage Publications Inc.
      place: Thousand Oaks, California
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        atl: Correlation of Motor-Task Related Brain Activation Changes With Motor Performance Changes Induced by Constraint-Induced Therapy After Stroke.
      aug:
        au:
          Wittenberg, George F.
          Leng, Xiaoyan
          Butler, Andrew J.
          Sathian, Krishnankutty
        affil: Wake Forest University SOM, Department of Neurology, Program in Rehabilitation, Winston-Salem, NC, USA
      sug:
        subj:
          Stroke Rehabilitation
          Frontal Lobe Physiopathology
          Constraint-Induced Therapy
          Brain Physiopathology
          Psychomotor Performance
          Stroke Complications
          Recovery
          Human
          Stroke Patients
          Hemiplegia Rehabilitation
          Magnetic Resonance Imaging Methods
          Task Performance and Analysis
          Functional Assessment
          Clinical Assessment Tools
          Funding Source
          Brain Mapping
          Motor Skills
      ab: Background: Steven Wolf made an exceptional effort to design, organize, and conduct a study of the biology of constraint induced movement therapy (CIMT) but only the transcranial magnetic stimulation results have been published previously. Objective: To evaluate changes in motor-task related brain activation and their relationship to functional recovery in participants with stroke undergoing CIMT during the subacute and chronic periods. Methods: Participants with hemiparetic stroke (n = 42) underwent fMRI of a hand task at baseline, immediately after a 2-week intervention or waiting period, and 4 months later, with effort or rate controlled at each timepoint. Functional outcome was assessed via the Wolf Motor Function Test (WMFT). Functional images were analyzed at the individual and group level. Results: Significant improvement in WMFT occurred in the intervention groups. Group-level changes in task-related activation over time were not significant. However, across all participants, increased WMFT task speed correlated significantly with increased ipsilesional M1 activation. No significant difference between activation changes were noted between any groups. Conclusions: Despite meaningful functional gains, longitudinal changes in cortical activation were limited when controlled for rate or effort, yet individual recovery was significantly associated with preserved or increased activation in the affected primary motor cortex. These results suggest that post-stroke motor recovery may reflect changes in how effort to move activates the stroke-affected motor cortex and more distal changes in response to motor cortical activation. Multi-site fMRI in stroke rehabilitation trials remains challenging, with strong control and monitoring of task performance needed.
      pubtype: Academic Journal
      doctype:
        diagnostic images
        research
        tables/charts
        Journal Article
      ougenre: Article
    language: English
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