Changes in brain activation in stroke patients after mental practice and physical exercise: a functional MRI study

Area of Science:

• Neurorehabilitation
• Motor control and learning
• Stroke recovery

Background:

• Mental practice, involving mental rehearsal of motor tasks, is an emerging rehabilitation technique.
• The precise neural mechanisms and brain activation patterns linked to motor recovery following mental practice remain unclear.
• Understanding these changes is crucial for optimizing stroke rehabilitation strategies.

Purpose of the Study:

• To investigate the effects of mental practice combined with physical practice on motor recovery in subcortical stroke patients.
• To explore the relationship between changes in brain activation and functional hand recovery after training.
• To identify specific brain regions involved in functional reorganization during mental practice.

Main Methods:

• Recruited 15 patients with first-ever subcortical stroke affecting the right hand.
• Assigned 10 patients to mental practice plus physical practice, and 5 to physical practice alone.
• Utilized functional MRI (fMRI) to observe brain activation changes after 4 weeks of training.
• Assessed hand function using the Fugl-Meyer assessment.

Main Results:

• The combined mental and physical practice group showed significantly greater improvement in Fugl-Meyer scores compared to the physical practice alone group.
• fMRI revealed enhanced activation in the left primary somatosensory cortex and right cerebellum.
• Attenuated activation intensity was observed in the right primary motor cortex during motor imagery tasks.
• Changes in brain cortical activity correlated with improvements in hand function.

Conclusions:

• Mental practice combined with physical practice is an effective strategy for enhancing hand function recovery post-stroke.
• Cortical and cerebellar functional reorganization underlies the observed improvements in hand function.
• This study highlights the potential of mental practice in neurorehabilitation.