Evidence of mirror therapy for recruitment of ipsilateral motor pathways in stroke recovery: A resting fMRI study

• DOI: 10.1016/j.neurot.2024.e00320
• Publication Date: 2024-01-22T17:33:16Z
• Authors: Kexu Zhang; Li Ding; Xu Wang; Jinyang Zhuang; Shanbao Tong; Jie Jia; Xiaoli Guo
• Keywords: Precentral gyrus; Stroke; Supplementary motor area

Mirror therapy (MT) has been proposed to promote motor recovery post-stroke through activation of mirror neuron system, recruitment ipsilateral pathways, or/and increasing attention toward the affected limb. However, neuroimaging evidence for these mechanisms is still lacking. To uncover underlying mechanisms, we designed a randomized controlled study and used voxel-based whole-brain analysis resting-state fMRI explore brain reorganizations induced by MT. Thirty-five stroke patients were an MT group (n ​= ​16) conventional (CT) ​19) 4-week intervention. Before after intervention, Fugl-Meyer Assessment Upper Limb subscale (FMA-UL) collected. A healthy cohort was established comparison. The changes in fractional amplitude low-frequency fluctuation (fALFF) seed-based functional connectivity analyzed investigate impact Results showed that greater FMA-UL improvement associated with compensatory increase fALFF contralesional precentral gyrus (M1) region re-establishment between bilateral M1 regions, which facilitate signals transmission via pathways from ipsilesional M1, step-wise linear regression model revealed two reorganization patterns collaboratively contributed improvement. In conclusion, achieved rehabilitation primarily pathways. Trial Registration Information: http://www.chictr.org.cn. Unique Identifier. ChiCTR-INR-17013644, submitted on December 2, 2017.