Exploratory study of how Cognitive Multisensory Rehabilitation restores parietal operculum connectivity and improves upper limb movements in chronic stroke

Sci Rep. 2020 Nov 20;10(1):20278. doi: 10.1038/s41598-020-77272-y.

Abstract

Cognitive Multisensory Rehabilitation (CMR) is a promising therapy for upper limb recovery in stroke, but the brain mechanisms are unknown. We previously demonstrated that the parietal operculum (parts OP1/OP4) is activated with CMR exercises. In this exploratory study, we assessed the baseline difference between OP1/OP4 functional connectivity (FC) at rest in stroke versus healthy adults to then explore whether CMR affects OP1/OP4 connectivity and sensorimotor recovery after stroke. We recruited 8 adults with chronic stroke and left hemiplegia/paresis and 22 healthy adults. Resting-state FC with the OP1/OP4 region-of-interest in the affected hemisphere was analysed before and after 6 weeks of CMR. We evaluated sensorimotor function and activities of daily life pre- and post-CMR, and at 1-year post-CMR. At baseline, we found decreased FC between the right OP1/OP4 and 34 areas distributed across all lobes in stroke versus healthy adults. After CMR, only four areas had decreased FC compared to healthy adults. Compared to baseline (pre-CMR), participants improved on motor function (MESUPES arm p = 0.02; MESUPES hand p = 0.03; MESUPES total score p = 0.006); on stereognosis (p = 0.03); and on the Frenchay Activities Index (p = 0.03) at post-CMR and at 1-year follow-up. These results suggest enhanced sensorimotor recovery post-stroke after CMR. Our results justify larger-scale studies.

Publication types

  • Clinical Trial
  • Research Support, N.I.H., Extramural
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Case-Control Studies
  • Chronic Disease / rehabilitation
  • Cognitive Behavioral Therapy / methods*
  • Connectome
  • Feedback, Sensory / physiology
  • Female
  • Follow-Up Studies
  • Healthy Volunteers
  • Humans
  • Magnetic Resonance Imaging
  • Male
  • Middle Aged
  • Movement / physiology
  • Parietal Lobe / diagnostic imaging
  • Parietal Lobe / physiology*
  • Pilot Projects
  • Recovery of Function / physiology
  • Rest / physiology
  • Stroke / physiopathology*
  • Stroke Rehabilitation / methods*
  • Treatment Outcome
  • Upper Extremity / physiology*