Functional and Structural Neural Correlates of Sensory Discrimination after Stroke
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2012
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ndltd-OhioLink-oai-etd.ohiolink.edu-osu13434094882021-08-03T06:06:02Z Functional and Structural Neural Correlates of Sensory Discrimination after Stroke Borstad, Alexandra Lee Rehabilitation stroke magnetic resonance imaging sensory discrimination diffusion tractography neural correlates <p>Stroke is the leading cause of serious long-term disability in the United States and worldwide. It is estimated that as many as 2.4 million persons in the United States are stroke survivors. A common and devastating impairment after stroke is one-sided paralysis which may be complete, known as hemiplegia, or partial, termed hemiparesis. Even when persisting impairments are mild, stroke survivors consistently express dissatisfaction with upper extremity recovery. Specifically, impairment in hand function has been shown to negatively influence health related quality of life. Unlike hemiparesis, sensory impairments are difficult to discern, yet research documents that up to 89% of individuals with hemiparesis demonstrate upper extremity sensory deficits when tested across domains of touch, temperature, weight, roughness, texture, and shape discrimination. Sensory dysfunction predicts the magnitude of recovery from movement focused training protocols, and is unchanged by those protocols yet, stroke rehabilitation protocols continue to focus on the motor impairment, largely ignoring the contributions of concomitant sensory deficits. While extensive literature documents the relationship between the brain’s structure and function in the post-stroke motor system, literature on post-stroke sensory systems is lacking. Here, in two descriptive, cross-sectional studies, multi-modal neuroimaging and behavioral measures of sensory function are used to document neural correlates of sensory function after stroke. A longitudinal pilot sensorimotor intervention study is described, as are methods to explore functional and structural brain reorganization related to treatment.</p><p>Sensorimotor training, which focuses on manual manipulation and sensory discrimination appears to be feasible, and shows potential as an effective approach, for improving motor function post-stroke; it bears further evaluation. Additional research is recommended to identify clinically useful measures of sensory function that are easily applied and span the breadth of tactile sensory behavior. Moreover, research regarding the best methods to translate sensory measurement and treatment into clinical routines is recommended. </p><p>Structural brain connectivity, measured with diffusion imaging, is diminished after stroke in a network of tracts that support sensory discrimination. This provides evidence that stroke has a general, as well as local, effect on white matter connectivity. This new finding has implications for sensorimotor rehabilitation, particularly in regard to bilateral training, because impaired connectivity in the non-lesioned hemisphere may affect the central mechanisms that result in a phasic relationship between limbs. </p><p>Finally, we suggested that activation in the precuneus cortex and structural reorganization of precuneus interhemisphereic connection reflect an increase in functional coupling between somatosensory areas in the right and left hemispheres that supports improved sensory discrimination after stroke. The implication, while preliminary, is that the precuneus cortex adapts to support function, and interventions that maximize this adaptation should be explored. More generally, this work illustrates that 32-direction diffusion imaging and probabilistic tractography methods provide meaningful representations of white matter structure after stroke.</p> 2012-08-24 English text The Ohio State University / OhioLINK http://rave.ohiolink.edu/etdc/view?acc_num=osu1343409488 http://rave.ohiolink.edu/etdc/view?acc_num=osu1343409488 unrestricted This thesis or dissertation is protected by copyright: all rights reserved. It may not be copied or redistributed beyond the terms of applicable copyright laws. |
| collection |
NDLTD |
| language |
English |
| sources |
NDLTD |
| topic |
Rehabilitation stroke magnetic resonance imaging sensory discrimination diffusion tractography neural correlates |
| spellingShingle |
Rehabilitation stroke magnetic resonance imaging sensory discrimination diffusion tractography neural correlates Borstad, Alexandra Lee Functional and Structural Neural Correlates of Sensory Discrimination after Stroke |
| author |
Borstad, Alexandra Lee |
| author_facet |
Borstad, Alexandra Lee |
| author_sort |
Borstad, Alexandra Lee |
| title |
Functional and Structural Neural Correlates of Sensory Discrimination after Stroke |
| title_short |
Functional and Structural Neural Correlates of Sensory Discrimination after Stroke |
| title_full |
Functional and Structural Neural Correlates of Sensory Discrimination after Stroke |
| title_fullStr |
Functional and Structural Neural Correlates of Sensory Discrimination after Stroke |
| title_full_unstemmed |
Functional and Structural Neural Correlates of Sensory Discrimination after Stroke |
| title_sort |
functional and structural neural correlates of sensory discrimination after stroke |
| publisher |
The Ohio State University / OhioLINK |
| publishDate |
2012 |
| url |
http://rave.ohiolink.edu/etdc/view?acc_num=osu1343409488 |
| work_keys_str_mv |
AT borstadalexandralee functionalandstructuralneuralcorrelatesofsensorydiscriminationafterstroke |
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