Proactive Motor Functional Recovery Following Immersive Virtual Reality–Based Limb Mirroring Therapy in Patients with Subacute Stroke
Virtual reality (VR) is considered to be a promising therapeutic technology for the rehabilitation of upper extremities (UEs) post-stroke. Recently, we designed and then implemented a neuroscientifically grounded VR protocol for the rehabilitation of patients with stroke. The system provides unilate...
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| Veröffentlicht in: | Neurotherapeutics 2020-10, Vol.17 (4), p.1919-1930 |
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| creator | Mekbib, Destaw B. Zhao, Zhiyong Wang, Jianbao Xu, Bin Zhang, Li Cheng, Ruiding Fang, Shan Shao, Yuling Yang, Wei Han, Jiawei Jiang, Hongjie Zhu, Junming Ye, Xiangming Zhang, Jianmin Xu, Dongrong |
| description | Virtual reality (VR) is considered to be a promising therapeutic technology for the rehabilitation of upper extremities (UEs) post-stroke. Recently, we designed and then implemented a neuroscientifically grounded VR protocol for the rehabilitation of patients with stroke. The system provides unilateral and bilateral limb mirroring exercises in a fully immersive virtual environment that may stimulate and activate the mirror neuron system in the brain to help patients for their rehabilitation. Twelve patients with subacute stroke underwent the newly implemented VR treatment in addition to conventional rehabilitation for 8 consecutive weekdays. The treatment effect on brain reorganization and motor function was investigated using resting-state fMRI (rs-fMRI) and the Fugl-Meyer assessment for Upper Extremity (FM-UE), respectively. Fifteen healthy controls (HCs) also underwent rs-fMRI scanning one time. The study finally obtained usable data from 8 patients and 13 HCs. After the intervention, patients demonstrated significant improvement in their FM-UE scores (
p
values |
| doi_str_mv | 10.1007/s13311-020-00882-x |
| format | Article |
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p
values < 0.042). Voxel-wise functional connectivity (FC) analysis based on the rs-fMRI data found that HCs showed widespread bilateral FC patterns associated with the dominant hemispheric primary motor cortex (M1). However, the FC patterns in patients revealed intra-hemispheric association with the ipsilesional M1 seed and this association became visible in the contra-hemisphere after the intervention. Moreover, the change of FC values between the bilateral M1 was significantly correlated with the changes in FM-UE scores (
p
values < 0.037). We conclude that unilateral and bilateral limb mirroring exercise in an immersive virtual environment may enhance cortical reorganization and lead to improved motor function.</description><identifier>ISSN: 1933-7213</identifier><identifier>ISSN: 1878-7479</identifier><identifier>EISSN: 1878-7479</identifier><identifier>DOI: 10.1007/s13311-020-00882-x</identifier><identifier>PMID: 32671578</identifier><language>eng</language><publisher>Cham: Springer International Publishing</publisher><subject>Biomedical and Life Sciences ; Biomedicine ; Brain mapping ; Computer applications ; Cortex (motor) ; Female ; Functional magnetic resonance imaging ; Humans ; Magnetic Resonance Imaging - methods ; Male ; Middle Aged ; Motor Cortex - diagnostic imaging ; Motor Cortex - physiology ; Neural networks ; Neurobiology ; Neurology ; Neurosciences ; Neurosurgery ; Original ; Original Article ; Psychomotor Performance - physiology ; Recovery (Medical) ; Recovery of function ; Recovery of Function - physiology ; Rehabilitation ; Stroke ; Stroke - diagnostic imaging ; Stroke - therapy ; Stroke Rehabilitation - methods ; Therapeutic applications ; Virtual reality ; Virtual Reality Exposure Therapy - methods</subject><ispartof>Neurotherapeutics, 2020-10, Vol.17 (4), p.1919-1930</ispartof><rights>The American Society for Experimental NeuroTherapeutics, Inc. 2020</rights><rights>The American Society for Experimental NeuroTherapeutics, Inc. 2020.</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c523t-668dedfc81f5704de3ef8357ca46fed142da73497b75e100432a6d08ec1326f33</citedby><cites>FETCH-LOGICAL-c523t-668dedfc81f5704de3ef8357ca46fed142da73497b75e100432a6d08ec1326f33</cites><orcidid>0000-0003-4682-1587</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC7851292/pdf/$$EPDF$$P50$$Gpubmedcentral$$H</linktopdf><linktohtml>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC7851292/$$EHTML$$P50$$Gpubmedcentral$$H</linktohtml><link.rule.ids>230,314,724,777,781,882,27905,27906,41469,42538,51300,53772,53774</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/32671578$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Mekbib, Destaw B.</creatorcontrib><creatorcontrib>Zhao, Zhiyong</creatorcontrib><creatorcontrib>Wang, Jianbao</creatorcontrib><creatorcontrib>Xu, Bin</creatorcontrib><creatorcontrib>Zhang, Li</creatorcontrib><creatorcontrib>Cheng, Ruiding</creatorcontrib><creatorcontrib>Fang, Shan</creatorcontrib><creatorcontrib>Shao, Yuling</creatorcontrib><creatorcontrib>Yang, Wei</creatorcontrib><creatorcontrib>Han, Jiawei</creatorcontrib><creatorcontrib>Jiang, Hongjie</creatorcontrib><creatorcontrib>Zhu, Junming</creatorcontrib><creatorcontrib>Ye, Xiangming</creatorcontrib><creatorcontrib>Zhang, Jianmin</creatorcontrib><creatorcontrib>Xu, Dongrong</creatorcontrib><title>Proactive Motor Functional Recovery Following Immersive Virtual Reality–Based Limb Mirroring Therapy in Patients with Subacute Stroke</title><title>Neurotherapeutics</title><addtitle>Neurotherapeutics</addtitle><addtitle>Neurotherapeutics</addtitle><description>Virtual reality (VR) is considered to be a promising therapeutic technology for the rehabilitation of upper extremities (UEs) post-stroke. Recently, we designed and then implemented a neuroscientifically grounded VR protocol for the rehabilitation of patients with stroke. The system provides unilateral and bilateral limb mirroring exercises in a fully immersive virtual environment that may stimulate and activate the mirror neuron system in the brain to help patients for their rehabilitation. Twelve patients with subacute stroke underwent the newly implemented VR treatment in addition to conventional rehabilitation for 8 consecutive weekdays. The treatment effect on brain reorganization and motor function was investigated using resting-state fMRI (rs-fMRI) and the Fugl-Meyer assessment for Upper Extremity (FM-UE), respectively. Fifteen healthy controls (HCs) also underwent rs-fMRI scanning one time. The study finally obtained usable data from 8 patients and 13 HCs. After the intervention, patients demonstrated significant improvement in their FM-UE scores (
p
values < 0.042). Voxel-wise functional connectivity (FC) analysis based on the rs-fMRI data found that HCs showed widespread bilateral FC patterns associated with the dominant hemispheric primary motor cortex (M1). However, the FC patterns in patients revealed intra-hemispheric association with the ipsilesional M1 seed and this association became visible in the contra-hemisphere after the intervention. Moreover, the change of FC values between the bilateral M1 was significantly correlated with the changes in FM-UE scores (
p
values < 0.037). We conclude that unilateral and bilateral limb mirroring exercise in an immersive virtual environment may enhance cortical reorganization and lead to improved motor function.</description><subject>Biomedical and Life Sciences</subject><subject>Biomedicine</subject><subject>Brain mapping</subject><subject>Computer applications</subject><subject>Cortex (motor)</subject><subject>Female</subject><subject>Functional magnetic resonance imaging</subject><subject>Humans</subject><subject>Magnetic Resonance Imaging - methods</subject><subject>Male</subject><subject>Middle Aged</subject><subject>Motor Cortex - diagnostic imaging</subject><subject>Motor Cortex - physiology</subject><subject>Neural networks</subject><subject>Neurobiology</subject><subject>Neurology</subject><subject>Neurosciences</subject><subject>Neurosurgery</subject><subject>Original</subject><subject>Original Article</subject><subject>Psychomotor Performance - physiology</subject><subject>Recovery (Medical)</subject><subject>Recovery of function</subject><subject>Recovery of Function - physiology</subject><subject>Rehabilitation</subject><subject>Stroke</subject><subject>Stroke - diagnostic imaging</subject><subject>Stroke - therapy</subject><subject>Stroke Rehabilitation - methods</subject><subject>Therapeutic applications</subject><subject>Virtual reality</subject><subject>Virtual Reality Exposure Therapy - methods</subject><issn>1933-7213</issn><issn>1878-7479</issn><issn>1878-7479</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2020</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>ABUWG</sourceid><sourceid>AFKRA</sourceid><sourceid>AZQEC</sourceid><sourceid>BENPR</sourceid><sourceid>CCPQU</sourceid><sourceid>DWQXO</sourceid><sourceid>GNUQQ</sourceid><recordid>eNp9kc1u1DAUhS0EomXgBVggS2zYBPyX2NkgQcVApamoaGFreZybjksSD7Yz7ey66wPwhjwJTqeUnwUr2_J3zz33HoSeUvKSEiJfRco5pQVhpCBEKVZc3kP7VElVSCHr-_lec15IRvkeehTjOSEl57V6iPY4qyQtpdpH18fBG5vcBvCRTz7g-Tjkpx9Mhz-B9RsIWzz3Xecv3HCGD_seQpzoLy6k8QYynUvbH1ff35oIDV64fomPXAg-TAWnKwhmvcVuwMcmORhSxBcurfDJuDR2TIBPUvBf4TF60JouwpPbc4Y-z9-dHnwoFh_fHx68WRS2ZDwVVaUaaFqraFtKIhrg0CpeSmtE1UJDBWuM5KKWS1lCXpLgzFQNUWBpnrnlfIZe73TX47KHxmZDwXR6HVxvwlZ74_TfP4Nb6TO_0VKVlNUsC7y4FQj-2wgx6d5FC11nBvBj1EwwIURVE5rR5_-g534MebMTpYRgUmWDM8R2lA0-xgDtnRlK9JSz3uWsc876Jmd9mYue_TnGXcmvYDPAd0BcTzlA-N37P7I_AaXsuCQ</recordid><startdate>20201001</startdate><enddate>20201001</enddate><creator>Mekbib, Destaw B.</creator><creator>Zhao, Zhiyong</creator><creator>Wang, Jianbao</creator><creator>Xu, Bin</creator><creator>Zhang, Li</creator><creator>Cheng, Ruiding</creator><creator>Fang, Shan</creator><creator>Shao, Yuling</creator><creator>Yang, Wei</creator><creator>Han, Jiawei</creator><creator>Jiang, Hongjie</creator><creator>Zhu, Junming</creator><creator>Ye, Xiangming</creator><creator>Zhang, Jianmin</creator><creator>Xu, Dongrong</creator><general>Springer International Publishing</general><general>Springer Nature B.V</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7RV</scope><scope>7TK</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>88G</scope><scope>8AO</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>AZQEC</scope><scope>BENPR</scope><scope>CCPQU</scope><scope>DWQXO</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>GNUQQ</scope><scope>K9.</scope><scope>KB0</scope><scope>M0S</scope><scope>M1P</scope><scope>M2M</scope><scope>NAPCQ</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>PSYQQ</scope><scope>Q9U</scope><scope>7X8</scope><scope>5PM</scope><orcidid>https://orcid.org/0000-0003-4682-1587</orcidid></search><sort><creationdate>20201001</creationdate><title>Proactive Motor Functional Recovery Following Immersive Virtual Reality–Based Limb Mirroring Therapy in Patients with Subacute Stroke</title><author>Mekbib, Destaw B. ; Zhao, Zhiyong ; Wang, Jianbao ; Xu, Bin ; Zhang, Li ; Cheng, Ruiding ; Fang, Shan ; Shao, Yuling ; Yang, Wei ; Han, Jiawei ; Jiang, Hongjie ; Zhu, Junming ; Ye, Xiangming ; Zhang, Jianmin ; Xu, Dongrong</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c523t-668dedfc81f5704de3ef8357ca46fed142da73497b75e100432a6d08ec1326f33</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2020</creationdate><topic>Biomedical and Life Sciences</topic><topic>Biomedicine</topic><topic>Brain mapping</topic><topic>Computer applications</topic><topic>Cortex (motor)</topic><topic>Female</topic><topic>Functional magnetic resonance imaging</topic><topic>Humans</topic><topic>Magnetic Resonance Imaging - methods</topic><topic>Male</topic><topic>Middle Aged</topic><topic>Motor Cortex - diagnostic imaging</topic><topic>Motor Cortex - physiology</topic><topic>Neural networks</topic><topic>Neurobiology</topic><topic>Neurology</topic><topic>Neurosciences</topic><topic>Neurosurgery</topic><topic>Original</topic><topic>Original Article</topic><topic>Psychomotor Performance - physiology</topic><topic>Recovery (Medical)</topic><topic>Recovery of function</topic><topic>Recovery of Function - physiology</topic><topic>Rehabilitation</topic><topic>Stroke</topic><topic>Stroke - diagnostic imaging</topic><topic>Stroke - therapy</topic><topic>Stroke Rehabilitation - methods</topic><topic>Therapeutic applications</topic><topic>Virtual reality</topic><topic>Virtual Reality Exposure Therapy - methods</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Mekbib, Destaw B.</creatorcontrib><creatorcontrib>Zhao, Zhiyong</creatorcontrib><creatorcontrib>Wang, Jianbao</creatorcontrib><creatorcontrib>Xu, Bin</creatorcontrib><creatorcontrib>Zhang, Li</creatorcontrib><creatorcontrib>Cheng, Ruiding</creatorcontrib><creatorcontrib>Fang, Shan</creatorcontrib><creatorcontrib>Shao, Yuling</creatorcontrib><creatorcontrib>Yang, Wei</creatorcontrib><creatorcontrib>Han, Jiawei</creatorcontrib><creatorcontrib>Jiang, Hongjie</creatorcontrib><creatorcontrib>Zhu, Junming</creatorcontrib><creatorcontrib>Ye, Xiangming</creatorcontrib><creatorcontrib>Zhang, Jianmin</creatorcontrib><creatorcontrib>Xu, Dongrong</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Nursing & Allied Health Database</collection><collection>Neurosciences Abstracts</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Medical Database (Alumni Edition)</collection><collection>Psychology Database (Alumni)</collection><collection>ProQuest Pharma Collection</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>ProQuest Central (Alumni Edition)</collection><collection>ProQuest Central UK/Ireland</collection><collection>ProQuest Central Essentials</collection><collection>ProQuest Central</collection><collection>ProQuest One Community College</collection><collection>ProQuest Central Korea</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Central Student</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Nursing & Allied Health Database (Alumni Edition)</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Medical Database</collection><collection>ProQuest Psychology</collection><collection>Nursing & Allied Health Premium</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest Central China</collection><collection>ProQuest One Psychology</collection><collection>ProQuest Central Basic</collection><collection>MEDLINE - Academic</collection><collection>PubMed Central (Full Participant titles)</collection><jtitle>Neurotherapeutics</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Mekbib, Destaw B.</au><au>Zhao, Zhiyong</au><au>Wang, Jianbao</au><au>Xu, Bin</au><au>Zhang, Li</au><au>Cheng, Ruiding</au><au>Fang, Shan</au><au>Shao, Yuling</au><au>Yang, Wei</au><au>Han, Jiawei</au><au>Jiang, Hongjie</au><au>Zhu, Junming</au><au>Ye, Xiangming</au><au>Zhang, Jianmin</au><au>Xu, Dongrong</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Proactive Motor Functional Recovery Following Immersive Virtual Reality–Based Limb Mirroring Therapy in Patients with Subacute Stroke</atitle><jtitle>Neurotherapeutics</jtitle><stitle>Neurotherapeutics</stitle><addtitle>Neurotherapeutics</addtitle><date>2020-10-01</date><risdate>2020</risdate><volume>17</volume><issue>4</issue><spage>1919</spage><epage>1930</epage><pages>1919-1930</pages><issn>1933-7213</issn><issn>1878-7479</issn><eissn>1878-7479</eissn><abstract>Virtual reality (VR) is considered to be a promising therapeutic technology for the rehabilitation of upper extremities (UEs) post-stroke. Recently, we designed and then implemented a neuroscientifically grounded VR protocol for the rehabilitation of patients with stroke. The system provides unilateral and bilateral limb mirroring exercises in a fully immersive virtual environment that may stimulate and activate the mirror neuron system in the brain to help patients for their rehabilitation. Twelve patients with subacute stroke underwent the newly implemented VR treatment in addition to conventional rehabilitation for 8 consecutive weekdays. The treatment effect on brain reorganization and motor function was investigated using resting-state fMRI (rs-fMRI) and the Fugl-Meyer assessment for Upper Extremity (FM-UE), respectively. Fifteen healthy controls (HCs) also underwent rs-fMRI scanning one time. The study finally obtained usable data from 8 patients and 13 HCs. After the intervention, patients demonstrated significant improvement in their FM-UE scores (
p
values < 0.042). Voxel-wise functional connectivity (FC) analysis based on the rs-fMRI data found that HCs showed widespread bilateral FC patterns associated with the dominant hemispheric primary motor cortex (M1). However, the FC patterns in patients revealed intra-hemispheric association with the ipsilesional M1 seed and this association became visible in the contra-hemisphere after the intervention. Moreover, the change of FC values between the bilateral M1 was significantly correlated with the changes in FM-UE scores (
p
values < 0.037). We conclude that unilateral and bilateral limb mirroring exercise in an immersive virtual environment may enhance cortical reorganization and lead to improved motor function.</abstract><cop>Cham</cop><pub>Springer International Publishing</pub><pmid>32671578</pmid><doi>10.1007/s13311-020-00882-x</doi><tpages>12</tpages><orcidid>https://orcid.org/0000-0003-4682-1587</orcidid><oa>free_for_read</oa></addata></record> |
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| source | MEDLINE; Elektronische Zeitschriftenbibliothek - Frei zugängliche E-Journals; Springer Nature - Complete Springer Journals; PubMed Central; Alma/SFX Local Collection |
| subjects | Biomedical and Life Sciences Biomedicine Brain mapping Computer applications Cortex (motor) Female Functional magnetic resonance imaging Humans Magnetic Resonance Imaging - methods Male Middle Aged Motor Cortex - diagnostic imaging Motor Cortex - physiology Neural networks Neurobiology Neurology Neurosciences Neurosurgery Original Original Article Psychomotor Performance - physiology Recovery (Medical) Recovery of function Recovery of Function - physiology Rehabilitation Stroke Stroke - diagnostic imaging Stroke - therapy Stroke Rehabilitation - methods Therapeutic applications Virtual reality Virtual Reality Exposure Therapy - methods |
| title | Proactive Motor Functional Recovery Following Immersive Virtual Reality–Based Limb Mirroring Therapy in Patients with Subacute Stroke |
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