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Concurrent tDCS-fMRI after stroke reveals link between attention network organization and motor improvement

任务正网络 经颅直流电刺激 冲程(发动机) 物理医学与康复 神经科学 初级运动皮层 脑刺激 运动皮层 认知 医学 中风恢复 神经影像学 慢性中风 刺激 心理学 默认模式网络 康复 物理 热力学
作者
Claudia Salazar,James W. Welsh,Daniel H. Lench,Irene E. Harmsen,Jens H. Jensen,Parneet Grewal,Milad Yazdani,Sami Al Kasab,Alex Spiotta,Leonardo Bonilha,Mark S. George,Steven A. Kautz,Nathan C. Rowland
出处
期刊:Scientific Reports [Nature Portfolio]
卷期号:14 (1)
标识
DOI:10.1038/s41598-024-70083-5
摘要

Restoring motor function after stroke necessitates involvement of numerous cognitive systems. However, the impact of damage to motor and cognitive network organization on recovery is not well understood. To discover correlates of successful recovery, we explored imaging characteristics in chronic stroke subjects by combining noninvasive brain stimulation and fMRI. Twenty stroke survivors (6 months or more after stroke) were randomly assigned to a single session of transcranial direct current stimulation (tDCS) or sham during image acquisition. Twenty healthy subjects were included as controls. tDCS was limited to 10 min at 2 mA to serve as a mode of network modulation rather than therapeutic delivery. Fugl-Meyer Assessments (FMA) revealed significant motor improvement in the chronic stroke group receiving active stimulation (p = 0.0005). Motor changes in this group were correlated in a data-driven fashion with imaging features, including functional connectivity (FC), surface-based morphometry, electric field modeling and network topology, focusing on relevant regions of interest. We observed stimulation-related changes in FC in supplementary motor (p = 0.0029), inferior frontal gyrus (p = 0.0058), and temporo-occipital (p = 0.0095) areas, though these were not directly related to motor improvement. The feature most strongly associated with FMA improvement in the chronic stroke cohort was graph topology of the dorsal attention network (DAN), one of the regions surveyed and one with direct connections to each of the areas with FC changes. Chronic stroke subjects with a greater degree of motor improvement had lower signal transmission cost through the DAN (p = 0.029). While the study was limited by a small stroke cohort with moderate severity and variable lesion location, these results nevertheless suggest a top-down role for higher order areas such as attention in helping to orchestrate the stroke recovery process.
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