Relationship between structural brainstem and brain plasticity and lower-limb training in spinal cord injury: a longitudinal pilot study
| Autor: | Villiger, Michael, Grabher, Patrick, Hepp-Reymond, Marie-Claude, Kiper, Daniel, Curt, Armin, Bolliger, Marc, Hotz-Boendermaker, Sabina, Kollias, Spyros, Eng, Kynan, Freund, Patrick |
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| Přispěvatelé: | University of Zurich, Villiger, Michael |
| Jazyk: | angličtina |
| Rok vydání: | 2015 |
| Předmět: |
610 Medicine & health
spinal cord injury structural plasticity 3206 Neuropsychology and Physiological Psychology 2738 Psychiatry and Mental Health Behavioral Neuroscience Psychiatry and Mental health virtual reality-augmented neurorehabilitation Neuropsychology and Physiological Psychology Neurology 10043 Clinic for Neuroradiology 2808 Neurology 2802 Behavioral Neuroscience Spinal cord injury Structural plasticity Lower limb Virtual reality-augmented neurorehabilitation Tensor-based morphometry Voxel-based morphometry lower limb voxel-based morphometry 10046 Balgrist University Hospital Swiss Spinal Cord Injury Center tensor-based morphometry 2803 Biological Psychiatry Biological Psychiatry Original Research 10194 Institute of Neuroinformatics Neuroscience |
| Zdroj: | Frontiers in Human Neuroscience Frontiers in Human Neuroscience, 9 |
| ISSN: | 1662-5161 |
| DOI: | 10.3389/fnhum.2015.00254 |
| Popis: | Rehabilitative training has shown to improve significantly motor outcomes and functional walking capacity in patients with incomplete spinal cord injury (iSCI). However, whether performance improvements during rehabilitation relate to brain plasticity or whether it is based on functional adaptation of movement strategies remain uncertain. This study assessed training improvement-induced structural brain plasticity in chronic iSCI patients using longitudinal MRI. We used tensor-based morphometry (TBM) to analyze longitudinal brain volume changes associated with intensive virtual reality (VR)-augmented lower limb training in nine traumatic iSCI patients. The MRI data was acquired before and after a 4-week training period (16–20 training sessions). Before training, voxel-based morphometry (VBM) and voxel-based cortical thickness (VBCT) assessed baseline morphometric differences in nine iSCI patients compared to 14 healthy controls. The intense VR-augmented training of limb control improved significantly balance, walking speed, ambulation, and muscle strength in patients. Retention of clinical improvements was confirmed by the 3–4 months follow-up. In patients relative to controls, VBM revealed reductions of white matter volume within the brainstem and cerebellum and VBCT showed cortical thinning in the primary motor cortex. Over time, TBM revealed significant improvement-induced volume increases in the left middle temporal and occipital gyrus, left temporal pole and fusiform gyrus, both hippocampi, cerebellum, corpus callosum, and brainstem in iSCI patients. This study demonstrates structural plasticity at the cortical and brainstem level as a consequence of VR-augmented training in iSCI patients. These structural changes may serve as neuroimaging biomarkers of VR-augmented lower limb neurorehabilitation in addition to performance measures to detect improvements in rehabilitative training. Frontiers in Human Neuroscience, 9 ISSN:1662-5161 |
| Databáze: | OpenAIRE |
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