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

dc.creatorFelipe Orihuela Espina
dc.creatorLuis Enrique Sucar Succar
dc.date2013
dc.date.accessioned2023-07-25T16:25:31Z
dc.date.available2023-07-25T16:25:31Z
dc.identifierhttp://inaoe.repositorioinstitucional.mx/jspui/handle/1009/2399
dc.identifier.urihttps://repositorioslatinoamericanos.uchile.cl/handle/2250/7807575
dc.descriptionGesture 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 for self-support. This therapy has demonstrated clinical value, but the underlying functional neural reorganization changes associated with this therapy that are responsible for the behavioral improvements are not yet known. Objective: We sought to quantify the occurrence of neural reorganization strategies that underlie motor improvements as they occur during the practice of Gesture Therapy and to identify those strategies linked to a better prognosis. Methods: Functional magnetic resonance imaging (fMRI) neuroscans were longitudinally collected at 4 time points during Gesture Therapy administration to 8 patients. Behavioral improvements were monitored using the Fugl-Meyer scale and Motricity Index. Activation loci were anatomically labelled and translated to reorganization strategies. Strategies are quantified by counting the number of active clusters in brain regions tied to them. Results: All patients demonstrated significant behavioral improvements (P< .05). Contralesional activation of the unaffected motor cortex, cerebellar recruitment, and compensatory prefrontal cortex activation were the most prominent strategies evoked. A strong and significant correlation between motor dexterity upon commencing therapy and total recruited activity was found (r2 = 0.80; P< .05), and overall brain activity during therapy was inversely related to normalized behavioral improvements (r2 = 0.64; P< .05). Conclusions: Prefrontal cortex and cerebellar activity are the driving forces of the recovery associated with Gesture Therapy. The relation between behavioral and brain changes suggests that those with stronger impairment benefit the most from this paradigm.
dc.formatapplication/pdf
dc.languageeng
dc.publisherThomas Land Publishers, Inc.
dc.relationcitation:Orihuela-Espina, F., et al., (2013). Neural Reorganization Accompanying Upper Limb Motor Rehabilitation from Stroke with Virtual Reality-Based Gesture Therapy, Topics in Stroke Rehabilitation, Vol. 20 (3): 197–209
dc.rightsinfo:eu-repo/semantics/openAccess
dc.rightshttp://creativecommons.org/licenses/by-nc-nd/4.0
dc.subjectinfo:eu-repo/classification/functional magnetic resonance imaging/functional magnetic resonance imaging
dc.subjectinfo:eu-repo/classification/Plasticity/Plasticity
dc.subjectinfo:eu-repo/classification/Rehabilitation/Rehabilitation
dc.subjectinfo:eu-repo/classification/Stroke/Stroke
dc.subjectinfo:eu-repo/classification/Virtual reality/Virtual reality
dc.subjectinfo:eu-repo/classification/cti/1
dc.subjectinfo:eu-repo/classification/cti/12
dc.subjectinfo:eu-repo/classification/cti/1203
dc.subjectinfo:eu-repo/classification/cti/1203
dc.titleNeural Reorganization Accompanying Upper Limb Motor Rehabilitation from Stroke with Virtual Reality-Based Gesture Therapy
dc.typeinfo:eu-repo/semantics/article
dc.typeinfo:eu-repo/semantics/acceptedVersion
dc.audiencestudents
dc.audienceresearchers
dc.audiencegeneralPublic


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