《Chinese Journal of Rehabilitation Theory and Practice》 ›› 2022, Vol. 28 ›› Issue (11): 1342-1348.doi: 10.3969/j.issn.1006-9771.2022.11.014

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Brain functioning between dominant and non-dominant hemispheres during rehabilitation for subacute stroke

LI Chaojinzi1,2a,HUANG Fubiao1,2b,DU Xiaoxia1,2a,ZHANG Haojie1,ZHANG Tong1,2a()   

  1. 1. Capital Medical University School of Rehabilitation Medicine, Beijing 100068, China
    2. a. Department of Neurological Rehabilitation; b. Department of Occupational Therapy, Beijing Bo'ai Hospital, China Rehabilitation Research Center, Beijing 100068, China
  • Received:2022-08-28 Revised:2022-09-26 Published:2022-11-25 Online:2022-12-20
  • Contact: ZHANG Tong E-mail:tom611@126.com
  • Supported by:
    China Rehabilitation Research Center Project(2020-Q4)

Abstract:

Objective To observe the differences of brain functioning between dominant and non-dominant hemispheres during rehabilitation for subacute stroke based on functional near-infrared spectroscopy (fNIRS).

Methods From September, 2019 to June, 2020, ten subacute stroke inpatients with left hemiplegia (non-dominant hemisphere group) and 16 with right hemiplegia (dominant hemisphere group) from Beijing Bo'ai Hospital received the same unilateral task-oriented occupational therapy for upper limbs, for four weeks. They were assessed with Action Research Arm Test, Fugl-Meyer Assessment-Upper Extremities and grip strength before and after treatment, and scanned with fNIRS to the β value of bilateral sensorimotor cortex, premotor cortex and prefrontal cortex according to the changes of oxyhemoglobin concentration.

Results All the indexes of assessment improved in the both groups after treatment (|t| > 3.253, P < 0.05), while the scores of Action Research Arm Test and grip strength improved more in the dominant hemisphere group than in the non-dominant hemisphere group (|t| > 2.154, P < 0.05). For the β value of fNIRS, there was no main effect on time, region and groups (F < 0.542, P> 0.05), and the interactive effect between region and group was significant (F = 4.226, P < 0.01): In the dominant hemisphere group, the β value was higher in the ipsilateral premotor cortex than in the contralateral cortex (P= 0.030), and it was less in the contralateral prefrontal cortex than in the ipsilateral sensorimotor cortex (P= 0.024), ipsilateral premotor cortex (P= 0.003) and ipsilateral prefrontal cortex (P = 0.018).

Conclusion For the subacute stroke patients with right hemiplegia, the activation of brain regions is different between dominant and non-dominant hemispheres during the rehabilitation of upper limb and hand.

Key words: stroke, subacute, upper limb, dominant hemisphere, functional near-infrared spectroscopy, brain plasticity

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