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The relationship between motor pathway damage and flexion-extension patterns of muscle co-excitation during walking.
Srivastava, Shraddha; Seamon, Bryant A; Marebwa, Barbara K; Wilmskoetter, Janina; Bowden, Mark G; Gregory, Chris M; Seo, Na Jin; Hanlon, Colleen A; Bonilha, Leonardo; Brown, Truman R; Neptune, Richard R; Kautz, Steven A.
Afiliación
  • Srivastava S; Ralph H. Johnson VA Medical Center, Charleston, SC, United States.
  • Seamon BA; Department of Health Sciences and Research, College of Health Professions, Medical University of South Carolina, Charleston, SC, United States.
  • Marebwa BK; Ralph H. Johnson VA Medical Center, Charleston, SC, United States.
  • Wilmskoetter J; Department of Health Sciences and Research, College of Health Professions, Medical University of South Carolina, Charleston, SC, United States.
  • Bowden MG; Division of Physical Therapy, Department of Rehabilitation Sciences, College of Health Professions, Medical University of South Carolina, Charleston, SC, United States.
  • Gregory CM; Department of Neurology, College of Medicine, Medical University of South Carolina, Charleston, SC, United States.
  • Seo NJ; Department of Health Sciences and Research, College of Health Professions, Medical University of South Carolina, Charleston, SC, United States.
  • Hanlon CA; Ralph H. Johnson VA Medical Center, Charleston, SC, United States.
  • Bonilha L; Department of Health Sciences and Research, College of Health Professions, Medical University of South Carolina, Charleston, SC, United States.
  • Brown TR; Division of Physical Therapy, Department of Rehabilitation Sciences, College of Health Professions, Medical University of South Carolina, Charleston, SC, United States.
  • Neptune RR; Ralph H. Johnson VA Medical Center, Charleston, SC, United States.
  • Kautz SA; Department of Health Sciences and Research, College of Health Professions, Medical University of South Carolina, Charleston, SC, United States.
Front Neurol ; 13: 968385, 2022.
Article en En | MEDLINE | ID: mdl-36388195
ABSTRACT

Background:

Mass flexion-extension co-excitation patterns during walking are often seen as a consequence of stroke, but there is limited understanding of the specific contributions of different descending motor pathways toward their control. The corticospinal tract is a major descending motor pathway influencing the production of normal sequential muscle coactivation patterns for skilled movements. However, control of walking is also influenced by non-corticospinal pathways such as the corticoreticulospinal pathway that possibly contribute toward mass flexion-extension co-excitation patterns during walking. The current study sought to investigate the associations between damage to corticospinal (CST) and corticoreticular (CRP) motor pathways following stroke and the presence of mass flexion-extension patterns during walking as evaluated using module analysis.

Methods:

Seventeen healthy controls and 44 stroke survivors were included in the study. We used non-negative matrix factorization for module analysis of paretic leg electromyographic activity. We typically have observed four modules during walking in healthy individuals. Stroke survivors often have less independently timed modules, for example two-modules presented as mass flexion-extension pattern. We used diffusion tensor imaging-based analysis where streamlines connecting regions of interest between the cortex and brainstem were computed to evaluate CST and CRP integrity. We also used a coarse classification tree analysis to evaluate the relative CST and CRP contribution toward module control.

Results:

Interhemispheric CST asymmetry was associated with worse lower extremity Fugl-Meyer score (p = 0.023), propulsion symmetry (p = 0.016), and fewer modules (p = 0.028). Interhemispheric CRP asymmetry was associated with worse lower extremity Fugl-Meyer score (p = 0.009), Dynamic gait index (p = 0.035), Six-minute walk test (p = 0.020), Berg balance scale (p = 0.048), self-selected walking speed (p = 0.041), and propulsion symmetry (p = 0.001). The classification tree model reveled that substantial ipsilesional CRP or CST damage leads to a two-module pattern and poor walking ability with a trend toward increased compensatory contralesional CRP based control.

Conclusion:

Both CST and CRP are involved with control of modules during walking and damage to both may lead to greater reliance on the contralesional CRP, which may contribute to a two-module pattern and be associated with worse walking performance.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Tipo de estudio: Prognostic_studies Idioma: En Revista: Front Neurol Año: 2022 Tipo del documento: Article País de afiliación: Estados Unidos

Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Tipo de estudio: Prognostic_studies Idioma: En Revista: Front Neurol Año: 2022 Tipo del documento: Article País de afiliación: Estados Unidos