Immediate effects of noxious and innocuous thermal stimulation on brain activation in patients with stroke

被引:5
|
作者
Chen, Sharon Chia-Ju [1 ,2 ]
Hsu, Miao-Ju [3 ]
Kuo, Yu-Ting [4 ,5 ]
Lin, Ruey-Tay [6 ]
Lo, Sing-Kai [7 ]
Lin, Jau-Hong [2 ,3 ]
机构
[1] Kaohsiung Med Univ, Dept Med Imaging & Radiol Sci, Kaohsiung, Taiwan
[2] Kaohsiung Med Univ Hosp, Dept Med Res, Kaohsiung, Taiwan
[3] Kaohsiung Med Univ, Dept Phys Therapy, Kaohsiung, Taiwan
[4] Chi Mei Med Ctr, Dept Med Imaging, Tainan, Taiwan
[5] Kaohsiung Med Univ, Dept Med Imaging, Chung Ho Mem Hosp, Kaohsiung, Taiwan
[6] Kaohsiung Med Univ, Coll Med, Dept Neurol, Kaohsiung, Taiwan
[7] Educ Univ Hong Kong, Fac Liberal Arts & Social Sci, Hong Kong, Peoples R China
关键词
brain activity; functional magnetic resonance imaging; rehabilitation; stimulation; stroke; RECOVERY; 3; MONTHS; MOTOR CORTEX; SOMATOSENSORY STIMULATION; UPPER EXTREMITY; CUTANEOUS HEAT; UPPER-LIMB; FMRI; COLD; PLASTICITY; PAIN;
D O I
10.1097/MD.0000000000019386
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
Case -control studies have shown that noxious thermal stimulation (TS) can improve arm function in patients with stroke. However. the neural mechanisms underlying this improvement are largely unknown. We explored functional neural activation due to noxious and innocuous TS intervention applied to the paretic arm of patients with stroke. Sixteen participants with unilateral cortical infarctions were allocated to one of two groups: noxious TS (8 patients; temperature combination: hot pain 46 degrees C to 47 degrees C, cold pain 7 degrees C-8 degrees C) or innocuous TS (n =8; temperature combination: hot 40 degrees C-41 degrees C, cold 20 degrees C-21 degrees C). All subjects underwent fMRI scanning before and after 30 min TS intervention and performed a finger tapping task with the affected hand. Immediate brain activation effects were assessed according to thermal type (noxious vs. innocuous TS) and time (pre -TS vs post -TS). Regions activated by noxious TS relative to innocuous TS (P <.05, adjusted for multiple comparisons) were related to motor performance and sensory function in the bilateral primary somatosensory cortices, anterior cingulate cortex, insula, thalamus, hippocampus and unilateral primary motor cortex, secondary somatosensory cortex at the contralateral side of lesion, and unilateral supplementary motor area at the ipsilateral side of lesion. Greater activation responses were observed in the side contralateral to the lesion, suggesting a significant intervention effect. Our preliminary findings suggest that noxious TS may induce neuroplastic changes unconstrained to the local area.
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页数:8
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