Changes in Prefrontal Cortex Asymmetry Due to Standing Load in Stroke Patients Measured by NIRS

Autonomic disorders such as orthostatic hypotension often become a problem during the early mobilization of poststroke patients. We reported that the prefrontal cortex (PFC) oxyhemoglobin changes at rest are often on the right, and a positive correlation was observed between the left and right activity balance and the change in oxy-Hb. In this study, we focused on the asymmetrical changes associated with the standing load from rest. We assessed the left-right asymmetry of the PFC oxyhemoglobin changes at rest and standing load by calculating the Laterality Index at Rest (LIR) and laterality index during activity (LIA); positive values indicate the right-dominant activity, while negative values indicate left-dominant activity. As for left-right asymmetry LIA, the active dominant PFC was reversed in five patients. It should be noted that in almost all of the 13 cases, the active PFC and the lesion side matched. The detailed mechanism of overactivity up to the prefrontal cortex on the lesion side is unknown, but it may be a recovery mechanism that elicits plasticity in the brain network.