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Stimulation of the Premotor Cortex Enhances Interhemispheric Functional Connectivity in Association with Upper Limb Motor Recovery in Moderate-to-Severe Chronic Stroke.
Unger, Robert H; Lowe, Mark J; Beall, Erik B; Bethoux, Francois; Jones, Stephen E; Machado, Andre G; Plow, Ela B; Cunningham, David A.
Afiliação
  • Unger RH; Department of Biomedical Engineering, Lerner Research Institute, Cleveland Clinic, Cleveland, Ohio, USA.
  • Lowe MJ; Cleveland Clinic Lerner College of Medicine, Case Western Reserve University, Cleveland, Ohio, USA.
  • Beall EB; Imaging Institute, Cleveland Clinic, Cleveland, Ohio, USA.
  • Bethoux F; Imaging Institute, Cleveland Clinic, Cleveland, Ohio, USA.
  • Jones SE; Center for Neurological Restoration, Neurological Institute, Cleveland Clinic, Cleveland, Ohio, USA.
  • Machado AG; Imaging Institute, Cleveland Clinic, Cleveland, Ohio, USA.
  • Plow EB; Center for Neurological Restoration, Neurological Institute, Cleveland Clinic, Cleveland, Ohio, USA.
  • Cunningham DA; Department of Biomedical Engineering, Lerner Research Institute, Cleveland Clinic, Cleveland, Ohio, USA.
Brain Connect ; 13(8): 453-463, 2023 10.
Article em En | MEDLINE | ID: mdl-36772802
Background: Transcranial direct current stimulation (tDCS) targeting the primary motor cortex is modestly effective for promoting upper-limb motor function following stroke. The premotor cortex (PMC) represents an alternative target based on its higher likelihood of survival and dense motor-network connections. Objective: The objective of this study was to determine whether ipsilesional PMC tDCS affects motor network functional connectivity (FC) in association with reduction in motor impairment, and to determine whether this relationship is influenced by baseline motor severity. Methods: Participants with chronic stroke were randomly assigned to receive active-PMC or sham-tDCS with rehabilitation for 5 weeks. Resting-state functional magnetic resonance imaging was acquired to characterize change in FC across motor-cortical regions. Results: Our results indicated that moderate-to-severe participants who received active-tDCS had greater increases in PMC-to-PMC interhemispheric FC compared to those who received sham; this increase was correlated with reduction in proximal motor impairment. There was also an increase in intrahemispheric dorsal premotor cortex-primary motor cortex FC across participants regardless of severity or tDCS group assignment; this increase was correlated with a reduction in proximal motor impairment in only the mild participants. Conclusions: Our findings have significance for developing targeted brain stimulation approaches. While participants with milder impairments may inherently recruit viable substrates within the ipsilesional hemisphere, stimulation of PMC may enhance interhemispheric FC in association with recovery in more impaired participants. Trial Registration: ClinicalTrials.gov Identifier: NCT01539096; Registration date: February 21, 2012.
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Texto completo: 1 Base de dados: MEDLINE Assunto principal: Acidente Vascular Cerebral / Estimulação Transcraniana por Corrente Contínua / Córtex Motor Idioma: En Ano de publicação: 2023 Tipo de documento: Article

Texto completo: 1 Base de dados: MEDLINE Assunto principal: Acidente Vascular Cerebral / Estimulação Transcraniana por Corrente Contínua / Córtex Motor Idioma: En Ano de publicação: 2023 Tipo de documento: Article