Author/Authors :
Xiao, Xiang Department of Rehabilitation Medicine - Guangdong Engineering Technology Research Center for Rehabilitation Medicine and Clinical Translation, The First Affiliated Hospital - Sun Yat-sen University, China , Lin, Qiang Department of Rehabilitation Medicine - Guangdong Engineering Technology Research Center for Rehabilitation Medicine and Clinical Translation, The First Affiliated Hospital - Sun Yat-sen University, China , Lo, Wai-Leung Department of Rehabilitation Medicine - Guangdong Engineering Technology Research Center for Rehabilitation Medicine and Clinical Translation, The First Affiliated Hospital - Sun Yat-sen University, China , Mao, Yu-Rong Department of Rehabilitation Medicine - Guangdong Engineering Technology Research Center for Rehabilitation Medicine and Clinical Translation, The First Affiliated Hospital - Sun Yat-sen University, China , Shi, Xin-chong epartment of Nuclear Medicine - The First Affiliated Hospital - Sun Yat-sen University, China , Cates, Ryan S Department of Pharmaceutical Sciences - College of Pharmacy - University of South Florida, uSA , Zhou, Shu-Feng Department of Pharmaceutical Sciences - College of Pharmacy - University of South Florida, uSA , Huang, Dong-Feng Department of Rehabilitation Medicine - Guangdong Engineering Technology Research Center for Rehabilitation Medicine and Clinical Translation, The First Affiliated Hospital - Sun Yat-sen University, China , Li, Le Department of Rehabilitation Medicine - Guangdong Engineering Technology Research Center for Rehabilitation Medicine and Clinical Translation, The First Affiliated Hospital - Sun Yat-sen University, China
Abstract :
Background. Functional magnetic resonance imaging (fMRI) is a promising method for quantifying brain recovery and
investigating the intervention-induced changes in corticomotor excitability after stroke. This study aimed to evaluate cortical
reorganization subsequent to virtual reality-enhanced treadmill (VRET) training in subacute stroke survivors. Methods. Eight
participants with ischemic stroke underwent VRET for 5 sections per week and for 3 weeks. fMRI was conducted to quantify the
activity of selected brain regions when the subject performed ankle dorsiflexion. Gait speed and clinical scales were also
measured before and after intervention. Results. Increased activation in the primary sensorimotor cortex of the lesioned
hemisphere and supplementary motor areas of both sides for the paretic foot (p < 0 01) was observed postintervention.
Statistically significant improvements were observed in gait velocity (p < 0 05). The change in voxel counts in the primary
sensorimotor cortex of the lesioned hemisphere is significantly correlated with improvement of 10 m walk time after VRET
(r = −0 719). Conclusions. We observed improved walking and increased activation in cortical regions of stroke survivors
after VRET training. Moreover, the cortical recruitment was associated with better walking function. Our study suggests
that cortical networks could be a site of plasticity, and their recruitment may be one mechanism of training-induced
recovery of gait function in stroke. This trial is registered with ChiCTR-IOC-15006064.
