Predicting efficacy of robot-aided rehabilitation in chronic stroke patients using an MRI-compatible robotic device

Abstract

We are investigating the neural correlates of motor recovery promoted by robot-mediated therapy in chronic stroke. This pilot study asked whether efficacy of robot-aided motor rehabilitation in chronic stroke could be predicted by a change in functional connectivity within the sensorimotor network in response to a bout of motor rehabilitation. To address this question, two stroke patients participated in a functional connectivity MRI study pre and post a 12-week robot-aided motor rehabilitation program. Functional connectivity was evaluated during three consecutive scans before the rehabilitation program: resting-state; point-to-point reaching movements executed by the paretic upper extremity (UE) using a newly developed MRI-compatible sensorized passive manipulandum; resting-state. A single resting-state scan was conducted after the rehabilitation program. Before the program, UE movement reduced functional connectivity between the ipsilesional and contralesional primary motor cortex. Reduced interhemispheric functional connectivity persisted during the second resting-state scan relative to the first and during the resting-state scan after the rehabilitation program. Greater reduction in interhemispheric functional connectivity during the resting-state was associated with greater gains in UE motor function induced by the 12-week robotic therapy program. These findings suggest that greater reduction in interhemispheric functional connectivity in response to a bout of motor rehabilitation may predict greater efficacy of the full rehabilitation program.

Beyond the Lesion: Neuroimaging Foundations For Post-Stroke Recovery

“…A greater reduction in intrinsic FC between ipsilesional and contralesional M1 was associated with greater gains in motor function after 12 weeks of robot-aided motor rehabilitation [126]. In relation to motor imagery, FC changes involving SMA, ipsilesional and contralesional M1, visual areas and cerebellum, predicted individual gain in motor function [127].…”

“…Intrinsic FC outcomes have been investigated in relation to a few interventions in stroke survivors: robot-aided motor rehabilitation [126]; brain-computer interface with motor imagery [127]; noradrenergic stimulation [123]; and an upper extremity accelerated skill acquisition program [108]. A greater reduction in intrinsic FC between ipsilesional and contralesional M1 was associated with greater gains in motor function after 12 weeks of robot-aided motor rehabilitation [126].…”

Robotic Technology for Spinal Cord Injury: Upper Extremity

“…İnme ile yapılan robotla tedavide kanıtlar, robot destekli tedaviden sonra beyin bağlantılarının reorganizasyonunun gerek bölgesel aktivasyon ve gerekse interhemisferik ve intrahemisferik fonksiyonel bağlantılar anlamında mümkün olduğunu desteklemektedir (3,10,11).…”

Compliant force-feedback actuation for accurate robot-mediated sensorimotor interaction protocols during fMRI

“…Other issues arise from experimental conditions that limit the possibility of motor protocols during fMRI. Most of the protocols presented so far involve shoulder and/or elbow movements [12], [13], [5], and it is well known that fMRI is very sensitive to head movements and to magnetic field changes related to the movement of body parts [14]. Both factors can lead to motion artifacts inducing false-positive activity or masking real brain activation.…”