Targeted Engagement of the Action Selection Network during Task-Oriented Arm Training after Stroke

Area of Science:

• Neurorehabilitation
• Motor Control
• Cognitive Neuroscience

Background:

• Action selection (AS) is a crucial motor planning process involving the frontal-parietal network.
• Integrating AS demands into arm training may enhance motor recovery after stroke by engaging this neural network.

Purpose of the Study:

• To assess the feasibility and outcomes of task-oriented arm training incorporating AS cues in individuals with chronic stroke.
• To investigate the impact of AS-focused training on behavioral performance and neural activation within the AS network.

Main Methods:

• A case series involving three participants with chronic stroke and mild to moderate motor deficits.
• Participants underwent 13-15 sessions of task-oriented arm training with AS cues (e.g., movement direction, height, distance).
• Functional MRI (fMRI) and behavioral assessments were conducted before and after the training intervention.

Main Results:

• All participants demonstrated improved AS behavioral performance, including increased accuracy and decreased reaction time.
• Two participants showed decreased brain activation in the AS network (dorsal premotor, parietal, dorsolateral prefrontal cortices) post-training.
• All participants achieved gains in motor function, notably in perceived difficulty and confidence for upper extremity tasks.

Conclusions:

• Task-oriented arm training with added AS demands is feasible for individuals with chronic stroke.
• This approach can effectively engage the AS behavioral process and associated neural networks.
• The training led to improvements in motor function and AS performance, suggesting potential for neurorehabilitation strategies.