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Shaping Early Reorganization of Neural Networks Promotes Motor Function after Stroke

Neural plasticity is a major factor driving cortical reorganization after stroke. We here tested whether repetitively enhancing motor cortex plasticity by means of intermittent theta-burst stimulation (iTBS) prior to physiotherapy might promote recovery of function early after stroke. Functional mag...

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Autores principales: Volz, L. J., Rehme, A. K., Michely, J., Nettekoven, C., Eickhoff, S. B., Fink, G. R., Grefkes, C.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Oxford University Press 2016
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4869817/
https://www.ncbi.nlm.nih.gov/pubmed/26980614
http://dx.doi.org/10.1093/cercor/bhw034
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author Volz, L. J.
Rehme, A. K.
Michely, J.
Nettekoven, C.
Eickhoff, S. B.
Fink, G. R.
Grefkes, C.
author_facet Volz, L. J.
Rehme, A. K.
Michely, J.
Nettekoven, C.
Eickhoff, S. B.
Fink, G. R.
Grefkes, C.
author_sort Volz, L. J.
collection PubMed
description Neural plasticity is a major factor driving cortical reorganization after stroke. We here tested whether repetitively enhancing motor cortex plasticity by means of intermittent theta-burst stimulation (iTBS) prior to physiotherapy might promote recovery of function early after stroke. Functional magnetic resonance imaging (fMRI) was used to elucidate underlying neural mechanisms. Twenty-six hospitalized, first-ever stroke patients (time since stroke: 1–16 days) with hand motor deficits were enrolled in a sham-controlled design and pseudo-randomized into 2 groups. iTBS was administered prior to physiotherapy on 5 consecutive days either over ipsilesional primary motor cortex (M1-stimulation group) or parieto-occipital vertex (control-stimulation group). Hand motor function, cortical excitability, and resting-state fMRI were assessed 1 day prior to the first stimulation and 1 day after the last stimulation. Recovery of grip strength was significantly stronger in the M1-stimulation compared to the control-stimulation group. Higher levels of motor network connectivity were associated with better motor outcome. Consistently, control-stimulated patients featured a decrease in intra- and interhemispheric connectivity of the motor network, which was absent in the M1-stimulation group. Hence, adding iTBS to prime physiotherapy in recovering stroke patients seems to interfere with motor network degradation, possibly reflecting alleviation of post-stroke diaschisis.
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spelling pubmed-48698172016-05-26 Shaping Early Reorganization of Neural Networks Promotes Motor Function after Stroke Volz, L. J. Rehme, A. K. Michely, J. Nettekoven, C. Eickhoff, S. B. Fink, G. R. Grefkes, C. Cereb Cortex Articles Neural plasticity is a major factor driving cortical reorganization after stroke. We here tested whether repetitively enhancing motor cortex plasticity by means of intermittent theta-burst stimulation (iTBS) prior to physiotherapy might promote recovery of function early after stroke. Functional magnetic resonance imaging (fMRI) was used to elucidate underlying neural mechanisms. Twenty-six hospitalized, first-ever stroke patients (time since stroke: 1–16 days) with hand motor deficits were enrolled in a sham-controlled design and pseudo-randomized into 2 groups. iTBS was administered prior to physiotherapy on 5 consecutive days either over ipsilesional primary motor cortex (M1-stimulation group) or parieto-occipital vertex (control-stimulation group). Hand motor function, cortical excitability, and resting-state fMRI were assessed 1 day prior to the first stimulation and 1 day after the last stimulation. Recovery of grip strength was significantly stronger in the M1-stimulation compared to the control-stimulation group. Higher levels of motor network connectivity were associated with better motor outcome. Consistently, control-stimulated patients featured a decrease in intra- and interhemispheric connectivity of the motor network, which was absent in the M1-stimulation group. Hence, adding iTBS to prime physiotherapy in recovering stroke patients seems to interfere with motor network degradation, possibly reflecting alleviation of post-stroke diaschisis. Oxford University Press 2016-06 2016-03-14 /pmc/articles/PMC4869817/ /pubmed/26980614 http://dx.doi.org/10.1093/cercor/bhw034 Text en © The Author 2016. Published by Oxford University Press. http://creativecommons.org/licenses/by-nc/4.0/ This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0/), which permits non-commercial re-use, distribution, and reproduction in any medium, provided the original work is properly cited. For commercial re-use, please contact journals.permissions@oup.com
spellingShingle Articles
Volz, L. J.
Rehme, A. K.
Michely, J.
Nettekoven, C.
Eickhoff, S. B.
Fink, G. R.
Grefkes, C.
Shaping Early Reorganization of Neural Networks Promotes Motor Function after Stroke
title Shaping Early Reorganization of Neural Networks Promotes Motor Function after Stroke
title_full Shaping Early Reorganization of Neural Networks Promotes Motor Function after Stroke
title_fullStr Shaping Early Reorganization of Neural Networks Promotes Motor Function after Stroke
title_full_unstemmed Shaping Early Reorganization of Neural Networks Promotes Motor Function after Stroke
title_short Shaping Early Reorganization of Neural Networks Promotes Motor Function after Stroke
title_sort shaping early reorganization of neural networks promotes motor function after stroke
topic Articles
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4869817/
https://www.ncbi.nlm.nih.gov/pubmed/26980614
http://dx.doi.org/10.1093/cercor/bhw034
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