| Part 1: Correlation between the Changes of Brain Amplitude of LowFrequency Fluctuation and Clinical Score following Ischemic StrokeObjective: To investigate the changes of amplitude of low frequency fluctuation(ALFF) of ischemic stroke by using resting state functional magnetic resonance imaging(rs-f MRI), and the correlation between ALFF and clinical scores.Methods: Eight ischemic patients(patient group) with right motor dysfunction and eight age-matched healthy participants(control group) were enrolled in this study. In each group, the rs-f MRI data were obtained and the ALFF images were calculated for each subject. After comparing the ALFF between the patient and control groups, the altered motor-related brain areas were selected as region of interests(ROIs). The correlations between the mean ALFF of each ROI and the clinical assessment including the Fugl-Meyer(FM) and Barthel Index(BI) were estimated.Results:(1) Compared with the control group, the ALFF of the patient group was significantly increased in the bilateral supplementary motor area(SMA), right primary motor cortex(M1), bilateral sub-thalamic nuclei,bilateral putamina and right pallidum; as well as significantly decreased in the left M1 and bilateral cerebellums(P < 0.05, uncorrected).(2) A significantly positive correlation was found between ALFF in the left SMA and FM(Correlation coefficient = 0.82; P = 0.01), as well asbetween ALFF in the left SMA and BI(Correlation coefficient = 0.90; P =0.002). The significantly positive correlation was seen between ALFF in the left thalamus and FM(Correlation coefficient = 0.78; P = 0.02), and also was seen between ALFF in the thalamus and BI(Correlation coefficient = 0.76; P= 0.03).Conclusion: After ischemic stroke, the spontaneous neural activity decreases in motor related brain areas in patients with motor dysfunction as reflected by the ALFF. These imaging manifestations are highly consistent with the degree of clinical motor impairment which proves that the ALFF may be used as a biomarker to estimate motor function of patients with motor dysfunction.Part 2:The Effects of Repetitive Transcranial Magnetic Stimulation on Ischemic Stroke Patients with Motor DysfunctionObjective: To investigate the effects of repetitive transcranial magnetic stimulation(rTMS) on motor function recovery after ischemic stroke by using amplitude of low frequency fluctuation(ALFF) and clinical assessments..Methods: Eight ischemic stroke patients were recruited in the rTMS group receiving high frequency rTMS(HF-rTMS) and conventional therapy.Other seven age-matched ischemic stroke patients were chosen as conventional therapy(CT) group receiving conventional therapy. The Fugl-Meyer(FM), Barthel Index(BI) and ALFF were measured before and after treatment in the two groups.Results:(1) Before treatment, there was no significant difference between rTMS group and CT group on FM and BI. Both group revealed significantly increased FM and BI scores after treatment(P < 0.05). Also, the greater FM and BI scores were also observed in rTMS group than CT group(P < 0.05).(2) In rTMS group, compared with the pre-treatment data, the ALFF significantly increased in the right thalamus, bilateral putamina and bilateral cerebellums, as well as decreased in the right primary motor cortex(M1), left supplementary motor area(SMA), and left thalamus after the treatment of rTMS(P<0.05, uncorrected).(3) There was not any significant pre-treatment difference between rTMS group and CT group in the ALFF(P > 0.05), but there were significant post-treatment differences observed in the following brain areas: the right putamen and left cerebellum which revealed increased ALFF; the right M1,bilateral SMA, right thalamus and right cerebellum, which revealed a decreased ALFF(P < 0.05, uncorrected).Conclusion: HF-rTMS may improve motor dysfunction after ischemic stroke. This might be associated with the mechanism that rTMS affects the neuronal activity of motor-related areas in the brain. |
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