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Bilateral versus ipsilesional cortico-subcortical activity patterns in stroke show hemispheric dependence

2017-01Journal article Restricted access
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dc.contributor.authorVidal, A. Cristina
dc.contributor.authorBanca, Paula
dc.contributor.authorPascoal, Augusto G.
dc.contributor.authorSanto, Gustavo C.
dc.contributor.authorSargento-Freitas, João
dc.contributor.authorGouveia, Ana
dc.contributor.authorCastelo-Branco, Miguel
dc.date.accessioned2017-11-20T15:20:46Z
dc.date.available2017-11-20T15:20:46Z
dc.date.issued2017-01
dc.description.abstractBackground Understanding of interhemispheric interactions in stroke patients during motor control is an important clinical neuroscience quest that may provide important clues for neurorehabilitation. In stroke patients, bilateral overactivation in both hemispheres has been interpreted as a poor prognostic indicator of functional recovery. In contrast, ipsilesional patterns have been linked with better motor outcomes. Aim We investigated the pathophysiology of hemispheric interactions during limb movement without and with contralateral restraint, to mimic the effects of constraint-induced movement therapy. We used neuroimaging to probe brain activity with such a movement-dependent interhemispheric modulation paradigm. Methods We used an fMRI block design during which the plegic/paretic upper limb was recruited/mobilized to perform unilateral arm elevation, as a function of presence versus absence of contralateral limb restriction ( n = 20, with balanced left/right lesion sites). Results Analysis of 10 right-hemispheric stroke participants yielded bilateral sensorimotor cortex activation in all movement phases in contrast with the unilateral dominance seen in the 10 left-hemispheric stroke participants. Superimposition of contralateral restriction led to a prominent shift from activation to deactivation response patterns, in particular in cortical and basal ganglia motor areas in right-hemispheric stroke. Left-hemispheric stroke was in general characterized by reduced activation patterns, even in the absence of restriction, which induced additional cortical silencing. Conclusion The observed hemispheric-dependent activation/deactivation shifts are novel and these pathophysiological observations suggest short-term neuroplasticity that may be useful for hemisphere-tailored neurorehabilitation.pt_PT
dc.description.versioninfo:eu-repo/semantics/publishedVersionpt_PT
dc.identifier.citationInt J Stroke. 2017 Jan;12(1):71-83. doi: 10.1177/1747493016672087pt_PT
dc.identifier.doi10.1177/1747493016672087pt_PT
dc.identifier.issn1747-4930
dc.identifier.issn1747-4949
dc.identifier.urihttp://hdl.handle.net/10400.26/19437
dc.language.isoengpt_PT
dc.peerreviewedyespt_PT
dc.publisherSAGE Publicationspt_PT
dc.relation.publisherversionhttps://doi.org/10.1177/1747493016672087pt_PT
dc.subjectStrokept_PT
dc.subjectfMRIpt_PT
dc.subjectHandednesspt_PT
dc.subjectInterhemispheric interactionspt_PT
dc.subjectMotor controlpt_PT
dc.subjectPhysiotherapypt_PT
dc.titleBilateral versus ipsilesional cortico-subcortical activity patterns in stroke show hemispheric dependencept_PT
dc.typejournal article
dspace.entity.typePublication
oaire.awardURIinfo:eu-repo/grantAgreement/FCT/SFRH/SFRH%2FBD%2F63848%2F2009/PT
oaire.awardURIinfo:eu-repo/grantAgreement/FCT/5876/UID%2FNEU%2F04539%2F2013/PT
oaire.citation.endPage83pt_PT
oaire.citation.startPage71pt_PT
oaire.citation.titleInternational Journal of Strokept_PT
oaire.citation.volume12(1)pt_PT
oaire.fundingStreamSFRH
oaire.fundingStream5876
project.funder.identifierhttp://doi.org/10.13039/501100001871
project.funder.identifierhttp://doi.org/10.13039/501100001871
project.funder.nameFundação para a Ciência e a Tecnologia
project.funder.nameFundação para a Ciência e a Tecnologia
rcaap.embargofctPolítica de copyright do editorpt_PT
rcaap.rightsrestrictedAccesspt_PT
rcaap.typearticlept_PT
relation.isProjectOfPublication003820a3-d4af-4ddf-b0a2-4fa663920317
relation.isProjectOfPublication9d33510f-cb66-44ae-a20b-2a13b5a7a763
relation.isProjectOfPublication.latestForDiscovery9d33510f-cb66-44ae-a20b-2a13b5a7a763

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