Effects of temporary functional deafferentation on the brain, sensation, and behavior of stroke patients

J Neurosci. 2012 Aug 22;32(34):11773-9. doi: 10.1523/JNEUROSCI.5912-11.2012.

Abstract

Following stroke, many patients suffer from chronic motor impairment and reduced somatosensation in the stroke-affected body parts. Recent experimental studies suggest that temporary functional deafferentation (TFD) of parts of the stroke-affected upper limb or of the less-affected contralateral limb might improve the sensorimotor capacity of the stroke-affected hand. The present study sought evidence of cortical reorganization and related sensory and motor improvements following pharmacologically induced TFD of the stroke-affected forearm. Examination was performed during 2 d of Constraint-Induced Movement Therapy. Thirty-six human patients were deafferented on the stroke-affected forearm by an anesthetic cream (containing lidocaine and prilocaine) on one of the 2 d, and a placebo cream was applied on the other. The order of TFD and placebo treatment was counterbalanced across patients. Somatosensory and motor performance were assessed using a Grating orienting task and a Shape-sorter-drum task, and with somatosensory-evoked magnetic fields. Evoked magnetic fields showed significant pre- to postevaluation magnitude increases in response to tactile stimulation of the thumb of the stroke-affected hand during TFD but not following placebo treatment. We also observed a rapid extension of the distance between cortical representations of the stroke-affected thumb and little finger following TFD but not following placebo treatment. Moreover, somatosensory and motor performance of the stroke-affected hand was significantly enhanced during TFD but not during placebo treatment. Thus, pharmacologically induced TFD of a stroke-affected forearm might improve the somatosensory and motor functions of the stroke-affected upper limb, accompanied by cortical plasticity.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Aged, 80 and over
  • Analysis of Variance
  • Anesthetics, Local / pharmacology
  • Cerebral Cortex / drug effects
  • Cerebral Cortex / physiopathology*
  • Child
  • Female
  • Forearm / innervation*
  • Functional Laterality / physiology
  • Humans
  • Lidocaine / pharmacology
  • Magnetic Resonance Imaging
  • Magnetoencephalography
  • Male
  • Middle Aged
  • Motion Therapy, Continuous Passive / methods*
  • Movement / physiology
  • Prilocaine / pharmacology
  • Psychomotor Performance / physiology*
  • Sensory Thresholds / physiology*
  • Stroke Rehabilitation
  • Stroke* / pathology
  • Stroke* / physiopathology
  • Time Factors

Substances

  • Anesthetics, Local
  • Prilocaine
  • Lidocaine