Avaliação por ressonância magnética funcional e estimulação magnética transcraniana da intervenção única da terapia espelho em pacientes após acidente vascular cerebral isquêmico
Mirror therapy (MT) is being used as a rehabilitation tool in various diseases, including stroke. Although some studies have shown its effectiveness, little is known about neural mechanisms that underlie the rehabilitation process. Therefore, this study aimed at assessing cortical neuromodulation af...
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| Formato: | Dissertação |
| Idioma: | por |
| Publicado em: |
Universidade Federal do Rio Grande do Norte
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| Endereço do item: | https://repositorio.ufrn.br/jspui/handle/123456789/17021 |
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| Resumo: | Mirror therapy (MT) is being used as a rehabilitation tool in various diseases, including
stroke. Although some studies have shown its effectiveness, little is known about neural
mechanisms that underlie the rehabilitation process. Therefore, this study aimed at
assessing cortical neuromodulation after a single MT intervention in ischemic stroke
survivors, by means of by functional Magnetic Resonance Imaging (fMRI) and
Transcranial Magnetic Stimulation (TMS). Fifteen patients participated in a single thirty
minutes MT session. fMRI data was analyzed bilaterally in the following Regions of
Interest (ROI): Supplementary Motor Area (SMA), Premotor cortex (PMC), Primary
Motor cortex (M1), Primary Sensory cortex (S1) and Cerebellum. In each ROI, changes
in the percentage of occupation and beta values were computed. Group fMRI data
showed a significant decreased in the percentage of occupation in PMC and cerebellum,
contralateral to the affected hand (p <0.05). Significant increase in beta values was
observed in the following contralateral motor areas: SMA, Cerebellum, PMC and M1
(p<0,005). Moreover, a significant decrease was observed in the following ipsilateral
motor areas: PMC and M1 (p <0,001). In S1 a bilateral significant decrease (p<0.0005)
was observed.TMS consisted of the analysis of Motor Evoked Potential (MEP) of M1
hotspot. A significant increase in the amplitude of the MEP was observed after therapy
in the group (p<0,0001) and individually in 4 patients (p <0.05). Altogether, our results
imply that single MT intervention is already capable of promoting changes in
neurobiological markers toward patterns observed in healthy subjects. Furthermore, the
contralateral hemisphere motor areas changes are opposite to the ones in the ipsilateral
side, suggesting an increase system homeostasis. |
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