Abstract

Purpose

Recent studies have revealed structural changes after motor rehabilitation, but its morphological changes related to upper limb motor behaviours have not been studied exhaustively. Therefore, we aimed to map the grey matter (GM) changes associated with motor rehabilitation after stroke using voxel-based morphometry (VBM), deformation-based morphometry (DBM), and surface-based morphometry (SBM).

Methods

Forty-one patients with chronic stroke received twelve sessions of low-frequency repetitive transcranial magnetic stimulation plus intensive occupational therapy. MRI data were obtained before and after the intervention. Fugl-Meyer Assessment and Wolf Motor Function Test-Functional Ability Scale were assessed at the two-time points. We performed VBM, DBM, and SBM analyses using T1-weighted images. A correlation analysis was performed between cortical thickness in motor areas and clinical outcomes.

Results

Clinical outcomes significantly improved after the intervention. VBM showed significant GM volume changes in ipsilesional and contralesional primary motor regions. DBM results demonstrated GM changes contralesionally and ipsilesionally after the intervention. SBM results showed significant cortical thickness changes in posterior visuomotor coordination, precentral, postcentral gyri of the ipsilesional hemisphere and contralesional visuomotor area after the intervention. A combination of threshold p < .05, False Discovery Rate and p < .001 (uncorrected) were considered significant. In addition, cortical thickness changes of the ipsilesional motor areas were significantly correlated with the clinical outcome changes.

Conclusions

We found GM structural changes in areas involved in motor, visuomotor and somatosensory functions after the intervention. Furthermore, our findings suggest that structural plasticity changes in chronic stroke could occur in the ipsilesional and contralesional hemispheres after motor rehabilitation.

中文翻译：

---

慢性卒中运动康复后脑形态测量学的变化

摘要

目的

最近的研究揭示了运动康复后的结构变化，但其与上肢运动行为相关的形态变化尚未得到详尽研究。因此，我们旨在使用基于体素的形态测量 (VBM)、基于变形的形态测量 (DBM) 和基于表面的形态测量 (SBM) 来绘制与中风后运动康复相关的灰质 (GM) 变化。

方法

41 名慢性中风患者接受了 12 次低频重复经颅磁刺激和强化职业治疗。在干预前后获得MRI数据。Fugl-Meyer 评估和 Wolf 运动功能测试-功能能力量表在两个时间点进行评估。我们使用 T1 加权图像进行了 VBM、DBM 和 SBM 分析。在运动区域的皮质厚度和临床结果之间进行了相关性分析。

结果

干预后临床结果显着改善。VBM 显示同侧和对侧初级运动区域的 GM 体积发生显着变化。DBM 结果表明，干预后 GM 发生了逆向和同向变化。SBM 结果显示干预后，后视运动协调、同侧半球的中央前回、中央后回和对侧视运动区的皮质厚度发生显着变化。阈值p < .05、错误发现率和p < .001（未校正）的组合被认为是显着的。此外，同侧运动区的皮质厚度变化与临床结果变化显着相关。

结论

我们发现干预后涉及运动、视觉运动和躯体感觉功能的区域发生了 GM 结构变化。此外，我们的研究结果表明，慢性卒中的结构可塑性变化可能发生在运动康复后的同侧和对侧半球。