Effect of repetitive arm cycling following botulinum toxin injection for poststroke spasticity: evidence from FMRI.
Neurorehabil Neural Repair
; 24(8): 753-62, 2010 Oct.
Article
em En
| MEDLINE
| ID: mdl-20663964
ABSTRACT
BACKGROUND AND OBJECTIVE:
Investigations were performed to establish if repetitive arm cycling training enhances the antispastic effect of intramuscular botulinum toxin (BTX) injections in postischemic spastic hemiparesis. Effects on cerebral activation were evaluated by functional magnetic resonance imaging (fMRI).METHODS:
Eight chronic spastic hemisyndrome patients (49 ± 10 years) after middle cerebral artery infarction (5.5 ± 2.7 years) were investigated. BTX was injected into the affected arm twice, 6 months apart. Spasticity was assessed using the Ashworth Scale and range of motion before and 3 months after BTX injections. Images were analyzed using Brain Voyager QX 1.8, and fMRI signal changes were corrected for multiple comparisons.RESULTS:
During passive movements of affected and nonaffected hands, fMRI activity was increased bilaterally in the sensorimotor cortex (MISI), secondary somatosensory areas (SII), and supplementary motor area predominantly in the contralesional hemisphere, compared with the rest. Following repetitive arm cycling, fMRI activity increased further in MISI of the lesioned hemisphere and SII of the contralesional hemisphere. For patients with residual motor activity, treatment-related fMRI activity increases were associated with reduced spasticity; in completely plegic patients, there was no fMRI activity change in SII but increased spasticity after training.CONCLUSION:
Increased activity in SII of the contralesional hemisphere and in MISI of the lesioned hemisphere reflect a treatment-induced effect in the paretic arm. It is hypothesized that the increased BOLD activity results from increased afferent information related to the antispastic BTX effect reinforced by training.
Texto completo:
1
Coleções:
01-internacional
Base de dados:
MEDLINE
Assunto principal:
Toxinas Botulínicas
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Imageamento por Ressonância Magnética
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Córtex Cerebral
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Antidiscinéticos
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Infarto da Artéria Cerebral Média
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Hemiplegia
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Movimento
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Espasticidade Muscular
Tipo de estudo:
Etiology_studies
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Observational_studies
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Prognostic_studies
/
Risk_factors_studies
Limite:
Adult
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Female
/
Humans
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Male
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Middle aged
Idioma:
En
Revista:
Neurorehabil Neural Repair
Assunto da revista:
NEUROLOGIA
/
REABILITACAO
Ano de publicação:
2010
Tipo de documento:
Article
País de afiliação:
Suíça