That Using Computer Exercise Upper Limb Of The Ischemic Stroke Patients Observe The Changes Of Brain Functional Magnetic Resonance Imaging

Background and Purpose:Computer-assisted technology is a new promising technology to promote motor recovery. However, it induced neuroplasticity supporting motor recovery is not known. We investigated the effects of computer-assisted technology intervention on cortical reorganization and associated motor recovery.Methods:From Nov.2007 to May.2008, We choose 12 healthy peoples and 10 stroke patients, they received computer-assisted exercise for 45minutes,5 times a week for 6 weeks. Computer-assisted exercise was designed to provide a virtual rehabilitation scence where the intensity of practice and sensory feedback could be systematically manipulated to provide the most appropriate, individualized motor retraining program, Laterality index (LI) in the regions of interests(ROIs) and motor recovery were measured before and after computer-assisted training using functional MRI for all subjects. Otherwise, standardized upper limb functional test straining contents included for stroke patients.Results:1. Computer-assisted therapy showed improvements in affected hand motor function after chronic stroke(p＜0.01).2. Prior to computer-assisted exercise, contralateral primary sensorimotor cortex (SMC) and ipsilateral cerebellum were activated during the motor task with dominant and no-dominant hand of normal subjects and unaffected hand of patients; After computer-assisted exercise, the actived areas of uninjured side hand of patients and the hands of normal subjects in the same stimulus task were increased in contralateral primary sensorimotor cortex (SMC) and part of the limbic system.3. Before training, the brain maps showed scattered activity in the contralateral primary sensorimotor cortex (SMC) which was weaken, the ipsilateral SMC and SMA which are increased during the affected wrist movement. After six weeks training, during the paretic wrist movement, activated regions were mainly in the contralateral and ipsilateral SMC,SMA,contralateral primary sensorimotor cortex and contralteral parietal lobule, the intensity of contralateral SMC is increaser than before.4. The changes of the scores of standardized upper limb functional test and the LI of SMC have positive correlation.Conclusion:1.Rehabilitation training can improve the ability of the affected upper limb motor for stroke patients.2. The actived volume and intensity of the ROIs in patients and abnormal people are enhanced after training.3. Computer-assisted training change of cortical activation pattern in the affected upper limb of chronic stroke patients.4. The changes of fMRI accompany with the change of upper limb function.