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. 2025 May 29;17(6):84.
doi: 10.3390/neurolint17060084.

Treatment-Associated Neuroplastic Changes in People with Stroke-Associated Ataxia-An fMRI Study

Patricia Meier  1   2 , Christian Siedentopf  3 , Lukas Mayer-Suess  1 , Michael Knoflach  1   2 , Stefan Kiechl  1   2 , Gudrun Sylvest Schönherr  4 , Astrid E Grams  3   5 , Elke R Gizewski  3 , Claudia Lamina  6 , Malik Galijasevic  3 , Ruth Steiger  3   5
Affiliations

Treatment-Associated Neuroplastic Changes in People with Stroke-Associated Ataxia-An fMRI Study

Patricia Meier et al. Neurol Int. .

Abstract

Background/Objectives: In consideration of the significance of the pursuit of training-induced neuroplastic changes in the stroke population, who are reliant on neurorehabilitation treatment for the restoration of neuronal function, the objectives of this trial were to investigate fMRI paradigms for acute stroke patients with ataxic symptoms, to follow up on changes in motor function and balance due to recovery and rehabilitation, and to investigate the different effects of two treatment methods on neuronal plasticity. Methods: Therefore, fMRI-paradigms foot tapping and the motor imagery (MI) of a balancing task (tandem walking) were employed. Results: The paradigms investigated were suitable for ataxic stroke patients to monitor changes in neuroplasticity while revealing increased activity in the primary motor cortex (M1) and the cerebellum over 3 months of treatment. Furthermore, analysis of the more complex balance task revealed augmented activation of association areas due to training. Coordination exercises, constituting a specific treatment of ataxic symptoms, indicate more consolidated brain activations, corresponding to a faster motor learning process. Activation within Brodmann Area 7 has been prominent among all paradigms, indicating a special importance of this region for coordinative functions. Conclusions: Further studies are needed to confirm our results in larger patient groups. Clinical Trial Registration: German Clinical Trials Registry (drks.de). Identifier: DRKS00020825. Registered 16.07.2020.

Keywords: acute stroke; ataxia; balance; coordination exercises; fMRI; foot tapping; motor imagery; neurorehabilitation; plasticity.

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Conflict of interest statement

The authors declare no conflicts of interest. The funders had no role in the design of the study; in the collection, analyses, or interpretation of data; in the writing of the manuscript; or in the decision to publish the results.

Figures

Figure 1
Figure 1
Study flow for one patient: MRI at T0 and T2.
Figure 2
Figure 2
A block design is used for functional motor mapping: A = task activation; R = rest. A total of 104 functional images (volumes) were measured, with eight volumes per block.
Figure 3
Figure 3
Functional magnetic resonance imaging paradigm—task activation: (a) image to prompt the foot tapping task; (b) video to prompt MI of the balancing task.
Figure 4
Figure 4
Example of translational (x, y, z) movement artifacts for foot tapping with the left foot: (a) from a patient with severe ataxia (SARA 20.5 points); (b) from a patient with moderate ataxia (SARA 9.5 points).
Figure 5
Figure 5
Activation patterns during foot tapping task (left side) in stroke patients with ataxia: (a) at T0; (b) at T2.
Figure 6
Figure 6
Activation patterns during MI of the balancing task in stroke patients with ataxia: (a) at T0; (b) at T2.
Figure 7
Figure 7
Changes in fMRI activation over the course of recovery and training: (a) during foot tapping task—left; (b) during foot tapping task—right.
Figure 8
Figure 8
Changes in fMRI activation over the course of recovery and training: during MI of the balancing task (T2 vs. T0).
Figure 9
Figure 9
Changes in activation of different brain regions due to treatment method (for foot tapping left): (a) the IG showed more active regions at baseline examination (T0 vs. T2); (b) the CG demonstrated more active regions after 3 months of practice (T2 vs. T0).
See this image and copyright information in PMC

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