Journal
EUROPEAN JOURNAL OF NEUROSCIENCE
Volume 56, Issue 4, Pages 4469-4485Publisher
WILEY
DOI: 10.1111/ejn.15754
Keywords
action selection; brain imaging; motor planning; stroke; upper extremity
Categories
Funding
- National Center for Medical Rehabilitation Research at the National Institutes of Health [R03 HD087481]
- American Heart Association [15SDG24970011, 20PRE35180106]
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Practice after stroke can improve action selection performance and reduce brain activation. Systematic changes in practice conditions may allow targeted treatment of specific components of the motor network during stroke rehabilitation.
Motor action selection engages a network of frontal and parietal brain regions. After stroke, individuals activate a similar network, however, activation is higher, especially in the contralesional hemisphere. The current study examined the effect of practice on action selection performance and brain activation after stroke. Sixteen individuals with chronic stroke (Upper Extremity Fugl-Meyer motor score range: 18-61) moved a joystick with the more-impaired hand in two conditions: Select (externally cued choice; move right or left based on an abstract rule) and Execute (simple response; move same direction every trial). On Day 1, reaction time (RT) was longer in Select compared to Execute, which corresponded to increased activation primarily in regions in the contralesional action selection network including dorsal premotor, supplementary motor, anterior cingulate and parietal cortices. After 4 days of practice, behavioural performance improved (decreased RT), and only contralesional parietal cortex significantly increased during Select. Higher brain activation on Day 1 in the bilateral action selection network, dorsolateral prefrontal cortex and contralesional sensory cortex predicted better performance on Day 4. Overall, practice led to improved action selection performance and reduced brain activation. Systematic changes in practice conditions may allow the targeting of specific components of the motor network during rehabilitation after stroke.
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