| Summary: | 碩士 === 國立中央大學 === 生物醫學工程研究所 === 104 === As the Taiwanese population structure converts into an aged society, stroke has become the second place among the highest medical causes of death. Following the stroke onset, continuous physical practice or exercise in the rehabilitation procedure stimulates the brain to re-organize its neural network, re-establishing the new functional connectivity to replace the injured neural assembly, known as the neural plasticity. However, the major assessment of neural plasticity now is based on subjective behavioral scores without objective neurophysiological quantitation. To better evaluate the efficacy of stroke rehabilitation, this study adopted clinical assessments and the functional magnetic imaging (fMRI) approaches to evaluate the brain plasticity alternation of stroke patients. We recruited a total of 12 healthy control and 15 stroke patients, among which 9 patients were assigned to the virtual reality rehabilitation (VRR) group and 6 for the traditional rehabilitation (TR) group. Both groups underwent the rehabilitation methods for a total of 24 hours, respectively, and they were assessed before rehabilitation, after rehabilitation and one-month follow-up after rehabilitation. For the fMRI, we focused on six major areas of the brain network associated with stroke. (1) ipsilesional primary motor cortex (iM1) (2) contralesional primary motor cortex network (cM1N); (3) ipsilesional attention network (iAN); (4) contralesional attention network (cAN); (5) default mode network (DMN); (6) supplementary motor area (SMA) network. Results showed a trend from abnormal bilateral M1 activation turning into unilateral activation after rehabilitation, while the patients grasped their affected hand. Meanwhile, the resting-state fMRI results showed that a unilateral M1 connectivity before rehabilitation turned into a bilateral M1 connectivity after rehabilitation. The DMN showed an enhanced connectivity with M1 after rehabilitation, implying that the DMN might play an important role in neuroplasticity following stroke. At last, the VRR group showed better recovery of resting-state functional connectivity along the stroke rehabilitation process, in contrast to the TR group.
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