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学科主题: 临床医学
题名:
Modulation of interhemispheric activation balance in motor-related areas of stroke patients with motor recovery: Systematic review and meta-analysis of fMRI studies
作者: McClure, Morgan A.1; Tang, Qing1; Li, Guangming2; Liu, Tao3; Wang, Anguo4; Feng, Shenggang5; Liao, Xiang1; Jin, Yu1; Guo, Zhiwei1; He, Bin1; Xing, Guoqiang6; Mu, Qiwen1,7
关键词: Interhemispheric activation balance ; Laterality index ; Stroke ; Motor recovery ; fMRI ; Sensorimotor cortex ; Premotor cortex ; Supplementary motor area ; Cerebellum
刊名: NEUROSCIENCE AND BIOBEHAVIORAL REVIEWS
发表日期: 2015-10-01
DOI: 10.1016/j.neubiorev.2015.09.003
卷: 57, 页:392-400
收录类别: SCI
文章类型: Review
WOS标题词: Science & Technology
类目[WOS]: Behavioral Sciences ; Neurosciences
研究领域[WOS]: Behavioral Sciences ; Neurosciences & Neurology
关键词[WOS]: INDUCED MOVEMENT THERAPY ; TRANSCRANIAL MAGNETIC STIMULATION ; INDUCED CORTICAL REORGANIZATION ; RANDOMIZED CONTROLLED-TRIAL ; UPPER-LIMB RECOVERY ; LONGITUDINAL FMRI ; VIRTUAL-REALITY ; PREMOTOR CORTEX ; HAND FUNCTION ; NEURAL REORGANIZATION
英文摘要:

Background: Functional magnetic resonance imaging (fMRI) studies suggest that stroke-induced motor deficits are associated with an interhemispheric imbalance of motor activation. This meta-analysis aims to determine the changes of interhemispheric activation balance (IHAB) in motor-related cortices along with post-stroke motor recovery.

Methods: We searched PubMed for fMRI studies that investigated IHAB in stroke patients with motor recovery. Laterality indexes (LIs, (ipsilesional activation - contralesional activation)/(ipsilesional activation + contralesional activation)) before and after motor improvement were extracted as the outcome measures of IHAB. Data were synthesized by calculating standardized mean difference (SMD, Hedges′ adjusted g) with 95% confidence intervals (Cl).

Results: After the rejection of 459 studies, 22 trials fulfilled the inclusion criteria and were included in the systematic review and meta-analysis. The Lis of sensorimotor cortex (SMC, 22 trials, 195 subjects), premotor cortex (PMC, 12 trials, 93 subjects), supplementary motor area (SMA, 12 trials, 92 subjects), and cerebellum (CB, 4 trials, 31 subjects) were assessed. Studies sampling from stroke patients with motor improvement showed positive changes of LI in SMC (SMD, 0.71; 95% Cl, 0.41-1.01; P<0.00001) and PMC (SMD, 0.68; 95% Cl, 0.36-1.00; P<0.0001), but not in SMA (SMD, 0.07; 95% Cl, -0.62 to 0.75; P=0.85) and CB (SMD, -0.17; 95% Cl, -1.52 to 1.19, P=0.81). Studies involving stroke patients with poor motor recovery showed non-significant changes in all of the four motor-related cortices (P>0.05).

Conclusions: This meta-analysis suggests that along with good motor recovery of stroke patients, the IHAB is up-regulated in SMC and PMC, but not significantly changed in SMA and CB. Because of the limited data, further studies are needed to verify the findings. (C) 2015 Elsevier Ltd. All rights reserved.

语种: 英语
所属项目编号: 81271559 ; 20155100056 ; 12JC0565 ; 110616
项目资助者: National Natural Science Foundation of China (NSFC) ; State Administration of Foreign Experts Affairs, the P.R. of China ; Science &amp ; Technology Department of Sichuan Province ; Scientific Research Project of Sichuan Health Department
WOS记录号: WOS:000364271200029
Citation statistics:
内容类型: 期刊论文
URI标识: http://ir.bjmu.edu.cn/handle/400002259/50323
Appears in Collections:北京大学第三临床医学院_期刊论文

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作者单位: 1.North Sichuan Med Univ, Nanchong Cent Hosp, Dept Urol Surg, Nanchong 637000, Sichuan, Peoples R China
2.North Sichuan Med Univ, Nanchong Cent Hosp, Dept Radiol & Imaging, Inst Rehabil & Dev Brain Funct, Nanchong 637000, Sichuan, Peoples R China
3.North Sichuan Med Univ, Nanchong Cent Hosp, Dept Oncol, Nanchong 637000, Sichuan, Peoples R China
4.North Sichuan Med Univ, Nanchong Cent Hosp, Dept Cardiol, Nanchong 637000, Sichuan, Peoples R China
5.North Sichuan Med Univ, Nanchong Cent Hosp, Dept Nephrol, Nanchong 637000, Sichuan, Peoples R China
6.Johns Hopkins Univ, MCC, Lotus Biotech Com LLC, Rockville, MD 20850 USA
7.Peking Univ, Hosp 3, Beijing 100080, Peoples R China

Recommended Citation:
McClure, Morgan A.,Tang, Qing,Li, Guangming,et al. Modulation of interhemispheric activation balance in motor-related areas of stroke patients with motor recovery: Systematic review and meta-analysis of fMRI studies[J]. NEUROSCIENCE AND BIOBEHAVIORAL REVIEWS,2015,57:392-400.
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