Recent evidence suggests that immobilization of the upper limb for 2–3 weeks induces changes in cortical thickness as well as motor performance. In constraint induced (CI) therapy, one of the most effective interventions for hemiplegia, the non-paretic arm is constrained to enforce the use of the paretic arm in the home setting. With the present study we aimed to explore whether non-paretic arm immobilization in CI therapy induces structural changes in the non-lesioned hemisphere, and how these changes are related to treatment benefit. 31 patients with chronic hemiparesis participated in CI therapy with (N = 14) and without (N = 17) constraint. Motor ability scores were acquired before and after treatment. Diffusion tensor imaging (DTI) data was obtained prior to treatment. Cortical thickness was measured with the Freesurfer software. In both groups cortical thickness in the contralesional primary somatosensory cortex increased and motor function improved with the intervention. However the cortical thickness change was not associated with the magnitude of motor function improvement. Moreover, the treatment effect and the cortical thickness change were not significantly different between the constraint and the non-constraint groups. There was no correlation between fractional anisotropy changes in the non-lesioned hemisphere and treatment outcome. CI therapy induced cortical thickness changes in contralesional sensorimotor regions, but this effect does not appear to be driven by the immobilization of the non-paretic arm, as indicated by the absence of differences between the constraint and the non-constraint groups. Our data does not suggest that the arm immobilization used in CI therapy is associated with noticeable cortical thinning.
Cortical thickness changes in the non-lesioned hemisphere associated with non-paretic arm immobilization in modified CI therapy☆
A. Sterr,Philip J. A. Dean,Gilson Vieira,A. Conforto,S. Shen,J. Sato
Published 2013 in NeuroImage: Clinical
ABSTRACT
PUBLICATION RECORD
- Publication year
2013
- Venue
NeuroImage: Clinical
- Publication date
2013-05-21
- Fields of study
Medicine, Psychology
- Identifiers
- External record
- Source metadata
Semantic Scholar, PubMed
CITATION MAP
EXTRACTION MAP
CLAIMS
CONCEPTS
- constraint group
The treatment arm that received constraint of the non-paretic arm.
Aliases: constraint condition
- constraint-induced therapy
A rehabilitation approach that restricts use of the non-paretic arm to encourage use of the paretic arm.
Aliases: CI therapy, modified CI therapy
- contralesional primary somatosensory cortex
The primary somatosensory cortex in the hemisphere opposite the lesion.
Aliases: contralesional S1
- cortical thickness
The measured thickness of the cerebral cortex obtained with Freesurfer.
Aliases: cortical thickness measure
- fractional anisotropy
A diffusion tensor imaging metric reflecting directional water diffusion in white matter.
Aliases: FA
- motor function improvement
The change in motor ability scores assessed before and after treatment.
Aliases: motor ability improvement
- non-constraint group
The treatment arm that received CI therapy without arm constraint.
Aliases: no-constraint group
- non-lesioned hemisphere
The cerebral hemisphere opposite the side of the lesion in these patients.
Aliases: contralesional hemisphere
- non-paretic arm immobilization
The physical restraint applied to the unaffected upper limb during treatment.
Aliases: constraint, arm constraint
- treatment outcome
The post-treatment change used to summarize benefit from the intervention.
Aliases: clinical outcome
REFERENCES
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