Sensorimotor, Attentional, and Neuroanatomical Predictors of Upper Limb Motor Deficits and Rehabilitation Outcome after Stroke

Abstract

The rehabilitation of motor deficits following stroke relies on both sensorimotor and cognitive abilities, thereby involving large-scale brain networks. However, few studies have investigated the integration between motor and cognitive domains, as well as its neuroanatomical basis. In this retrospective study, upper limb motor responsiveness to technology-based rehabilitation was examined in a sample of 29 stroke patients (18 with right and 11 with left brain damage). Pretreatment sensorimotor and attentional abilities were found to influence motor recovery. Training responsiveness increased as a function of the severity of motor deficits, whereas spared attentional abilities, especially visuospatial attention, supported motor improvements. Neuroanatomical analysis of structural lesions and white matter disconnections showed that the poststroke motor performance was associated with putamen, insula, corticospinal tract, and frontoparietal connectivity. Motor rehabilitation outcome was mainly associated with the superior longitudinal fasciculus and partial involvement of the corpus callosum. The latter findings support the hypothesis that motor recovery engages large-scale brain networks that involve cognitive abilities and provides insight into stroke rehabilitation strategies.

A Novel Online Action Observation-Based Brain–Computer Interface That Enhances Event-Related Desynchronization

“…Furthermore, attention and motor rehabilitation showed a certain relationship in the post-stoke rehabilitation outcome [44]. One recent study reported that selective attention skills were positively related to the Fugl-Meyer upper extremity recovery index after stroke [45]. Robertson et al observed that preserved attention skills could positively impact the motor rehabilitation outcome [46].…”

Clinical Predictors for Upper Limb Recovery after Stroke Rehabilitation: Retrospective Cohort Study

“…Moreover, the retrospective nature of the study design and the absence of a control group did not allow to explore strong cause-and-effect relationships [41]. Therefore, there is the need to test our findings on larger sample, to improve the model's statistical fitting and estimation precision for having an accurate view on the potential influence of the cognitive and linguistic functions on motor recovery, more consistent with current literature [11].…”

“…In addition, another underresearched aspect is how cognitive-linguistic and motor functions influence each other and mutually contribute to functional recovery, after stroke. In fact, recent evidence showed that cognitive abilities (especially attention) support motor recovery, throughout large-scale brain networks connecting both cognitive and motor areas [11]. It is therefore reasonable consider these impairments affecting not only the recovery pattern, but also activities of everyday life [12].…”

Low-Frequency Repetitive Transcranial Magnetic Stimulation Restores Dynamic Functional Connectivity in Subcortical Stroke

“…The main feature of state I was the stronger positive correlation between networks, including AUN, VIS, SMN, and DMN, and this may be a potential compensatory mechanism for internal brain networks. Information integration between large-scale networks after stroke may compensate for the local loss of neural tissue and function ( 25 ). Therefore, we believe that this result was due to the inclusion of only moderate and severe patients with stroke.…”