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. 2022:33:102931.
doi: 10.1016/j.nicl.2021.102931. Epub 2021 Dec 29.

MRI markers of functional connectivity and tissue microstructure in stroke-related motor rehabilitation: A systematic review

E Tavazzi  1 , N Bergsland  2 , A Pirastru  3 , M Cazzoli  3 , V Blasi  3 , F Baglio  3
Affiliations

MRI markers of functional connectivity and tissue microstructure in stroke-related motor rehabilitation: A systematic review

E Tavazzi et al. Neuroimage Clin. 2022.

Abstract

Background: Stroke-related disability is a major problem at individual and socio-economic levels. Neuromotor rehabilitation has a key role for its dual action on affected body segment and brain reorganization. Despite its known efficacy in clinical practice, the extent and type of effect at a brain level, mediated by neuroplasticity, are still under question.

Objective: To analyze studies applying MRI markers of functional and structural connectivity in patients affected with stroke undergoing motor rehabilitation, and to evaluate the effect of rehabilitation on brain reorganization.

Methods: Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) criteria were applied to select studies applying quantitative non-conventional MRI techniques on patients undergoing motor rehabilitation, both physical and virtual (virtual reality, mental imagery). Literature search was conducted using MEDLINE (via PubMed), Cochrane Central Register of Controlled Trials (CENTRAL), and EMBASE from inception to 30th June 2020.

Results: Forty-one out of 6983 papers were included in the current review. Selected studies are heterogeneous in terms of patient characteristics as well as type, duration and frequency of rehabilitative approach. Neuromotor rehabilitation promotes neuroplasticity, favoring functional recovery of the ipsilesional hemisphere and activation of anatomically and functionally related brain areas in both hemispheres, to compensate for damaged tissue.

Conclusions: The evidence derived from the analyzed studies supports the positive impact of rehabilitation on brain reorganization, despite the high data heterogeneity. Advanced MRI techniques provide reliable markers of structural and functional connectivity that may potentially aid in helping to implement the most appropriate rehabilitation intervention.

Keywords: Connectivity; MRI; Neuroplasticity; Rehabilitation; Stroke; fMRI.

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Conflict of interest statement

The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper.

Figures

Fig. 1
Fig. 1
Examples of images derived from task-based fMRI (upper left), resting-state fMRI (upper right), voxel based-morphometry (lower left) and diffusion tensor imaging (lower right).
Fig. 2
Fig. 2
Flow-chart of the papers selection process.
See this image and copyright information in PMC

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