TY  - JOUR
AU  - Volz, L. J.
AU  - Rehme, A. K.
AU  - Michely, J.
AU  - Nettekoven, C.
AU  - Eickhoff, Simon
AU  - Fink, G. R.
AU  - Grefkes, Christian
TI  - Shaping Early Reorganization of Neural Networks Promotes Motor Function after Stroke.
JO  - Cerebral cortex
VL  - 26
IS  - 6
SN  - 1460-2199
CY  - Oxford
PB  - Oxford Univ. Press
M1  - FZJ-2016-02168
SP  - 2882-2894
PY  - 2016
AB  - Neural plasticity is a major factor driving cortical reorganization after stroke. We here tested whether repetitively enhancing motor cortex plasticity by means of intermittent theta-burst stimulation (iTBS) prior to physiotherapy might promote recovery of function early after stroke. Functional magnetic resonance imaging (fMRI) was used to elucidate underlying neural mechanisms. Twenty-six hospitalized, first-ever stroke patients (time since stroke: 1-16 days) with hand motor deficits were enrolled in a sham-controlled design and pseudo-randomized into 2 groups. iTBS was administered prior to physiotherapy on 5 consecutive days either over ipsilesional primary motor cortex (M1-stimulation group) or parieto-occipital vertex (control-stimulation group). Hand motor function, cortical excitability, and resting-state fMRI were assessed 1 day prior to the first stimulation and 1 day after the last stimulation. Recovery of grip strength was significantly stronger in the M1-stimulation compared to the control-stimulation group. Higher levels of motor network connectivity were associated with better motor outcome. Consistently, control-stimulated patients featured a decrease in intra- and interhemispheric connectivity of the motor network, which was absent in the M1-stimulation group. Hence, adding iTBS to prime physiotherapy in recovering stroke patients seems to interfere with motor network degradation, possibly reflecting alleviation of post-stroke diaschisis.
LB  - PUB:(DE-HGF)16
C6  - pmid:26980614
UR  - <Go to ISI:>//WOS:000377917500041
DO  - DOI:10.1093/cercor/bhw034
UR  - https://juser.fz-juelich.de/record/807750
ER  -