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024 7 _ |a 10.1093/cercor/bhw034
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100 1 _ |a Volz, L. J.
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245 _ _ |a Shaping Early Reorganization of Neural Networks Promotes Motor Function after Stroke.
260 _ _ |a Oxford
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520 _ _ |a 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.
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700 1 _ |a Rehme, A. K.
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700 1 _ |a Michely, J.
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700 1 _ |a Nettekoven, C.
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700 1 _ |a Eickhoff, Simon
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700 1 _ |a Fink, G. R.
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700 1 _ |a Grefkes, Christian
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773 _ _ |a 10.1093/cercor/bhw034
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