Neural Reorganization Accompanying Upper Limb Motor Rehabilitation from Stroke with Virtual Reality-Based Gesture Therapy

• DOI: 10.1310/tsr2003-197
• Publication Date: 2013-07-11T01:02:47Z
• Authors: Felipe Orihuela-E...; Isabel Fernández ...; Lorena Palafox; Erick Pasaye; Israel Sánchez-Vi...; Ronald Leder; Jorge Hernández F...; Luis Enrique Sucar
• Keywords: Stroke; Supplementary motor area

Background: Gesture Therapy is an upper limb virtual reality rehabilitation-based therapy for stroke survivors. It promotes motor rehabilitation by challenging patients with simple computer games representative of daily activities self-support. This has demonstrated clinical value, but the underlying functional neural reorganization changes associated this that are responsible behavioral improvements not yet known. Objective: We sought to quantify occurrence strategies underlie as they occur during practice and identify those linked a better prognosis. Methods: Functional magnetic resonance imaging (fMRI) neuroscans were longitudinally collected at 4 time points administration 8 patients. Behavioral monitored using Fugl-Meyer scale Motricity Index. Activation loci anatomically labelled translated strategies. Strategies quantified counting number active clusters in brain regions tied them. Results: All significant (P < .05). Contralesional activation unaffected cortex, cerebellar recruitment, compensatory prefrontal cortex most prominent evoked. A strong correlation between dexterity upon commencing total recruited activity was found (r2 = 0.80; P .05), overall inversely related normalized 0.64; Conclusions: Prefrontal driving forces recovery Therapy. The relation suggests stronger impairment benefit from paradigm.