Functional MRI with Motor Imagery Task Show CNS Effects and Brain Plasticity after Botulinum Toxin Therapy in Spastic Hemiplegic Stroke Patients

摘要: Introduction: Botulinum toxin is considered a first-line treatment for focal spasticity after stroke, and its peripheral effects have been well documented. We set out to demonstrate describe any it may in the central nervous system, using fMRI record brain activation patterns before administration. Materials Methods: 17 subjects comprising 7 ischemic stroke patients affected by upper limb spastic hemiplegia, 10 healthy controls were recruited underwent three scans while performing motor imagery task (finger tapping). Test botulinum therapy (T0), 4 weeks later (T1), 8 (T2), untreated control tested at 0, weeks. The finger-tapping was performed twice each session both groups. Both test only daily passive muscle stretching exercises between T0, T1, T2 MR scans. Results: confirmed technical feasibility of “motor imagery” paradigm activating areas subjects. While second-level analysis group showed no modification pattern during T2, increasing focalization mean activation, accompanied gradual reduction secondary area (SMA Brodmann 6) group. Conclusions: This confirms efficacy as an open “window” into that enables us study processes function recovery vivo. Our data show injection alone brings about progressive alteration reorganization cortical thereby confirming therapeutic effects. greater seen continued over time, line with latest “small world network” theories on subcortical cerebral functions stroke.