Background. Reorganization in motor areas have been suggested after motor imagery training (MIT). However, motor imagery involves a large-scale brain network, in which many regions, andnot only the motor areas, potentially constitute the neural substrate for MIT. Objective. This study aimed to identify the targets for MIT in stroke rehabilitation from a voxel-based whole brain analysis of resting-state functional magnetic resonance imaging (fMRI). Methods. Thirty-four chronic stroke patients were recruited and randomly assigned to either an MIT group or a control group. The MIT group received a 4-week treatment of MIT plus conventional rehabilitation therapy (CRT), whereas the control group only received CRT. Before and after intervention, the Fugl-Meyer Assessment Upper Limb subscale (FM-UL) and resting-state fMRI were collected. The fractional amplitude of low-frequency fluctuations (fALFF) in the slow-5 band (0.01-0.027 Hz) was calculated across the whole brain to identify brain areas with distinct changes between 2 groups. These brain areas were then targeted as seeds to perform seed-based functional connectivity (FC) analysis. Results. In comparison with the control group, the MIT group exhibited more improvements in FM-UL and increased slow-5 fALFF in the ipsilesional inferior parietal lobule (IPL). The change of the slow-5 oscillations in the ipsilesional IPL was positively correlated with the improvement of FM-UL. The MIT group also showed distinct alternations in FCs of the ipsilesional IPL, which were correlated with the improvement of FM-UL. Conclusions. The rehabilitation efficiency of MIT was associated with increased slow-5 oscillations and altered FC in the ipsilesional IPL. Clinical Trial Registration. http://www.chictr.org.cn. Unique Identifier. ChiCTR-TRC-08003005.

中文翻译：

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中风后的运动意象训练增加同侧顶叶下小叶的慢 5 振荡和功能连接

背景。在运动意象训练（MIT）之后，有人建议在运动区域进行重组。然而，运动意象涉及一个大规模的大脑网络，其中许多区域，而不仅仅是运动区域，潜在地构成了麻省理工学院的神经基础。客观的。本研究旨在通过静息态功能磁共振成像 (fMRI) 的基于体素的全脑分析来确定 MIT 在中风康复中的目标。方法。招募了 34 名慢性卒中患者并随机分配到 MIT 组或对照组。MIT组接受了为期4周的MIT治疗加常规康复治疗（CRT），而对照组仅接受了CRT。在干预前后，收集了 Fugl-Meyer 评估上肢分量表 (FM-UL) 和静息状态 fMRI。在整个大脑中计算慢 5 波段 (0.01-0.027 Hz) 中低频波动的分数幅度 (fALFF)，以确定两组之间具有明显变化的大脑区域。然后将这些大脑区域作为种子进行基于种子的功能连接 (FC) 分析。结果。与对照组相比，MIT 组的 FM-UL 改善更多，同侧顶叶下小叶 (IPL) 的slow-5 fALFF 增加。同侧 IPL 中慢 5 振荡的变化与 FM-UL 的改善呈正相关。MIT 组还显示出同侧 IPL 的 FC 的明显变化，这与 FM-UL 的改善相关。结论。MIT 的康复效率与增加的慢 5 振荡和同侧 IPL 中的 FC 改变有关。临床试验注册。http://www.chictr.org.cn。唯一标识符。ChiCTR-TRC-08003005。