29. Changes in brain activation after therapeutic stimulation using Vojta therapy: Controlled study

Abstract

Introduction The aim of this study was to assess the changes in brain activation patterns in healthy volunteers after therapeutic stimulation using Vojta therapy. Although the efficacy of this treatment has been supported by clinical studies, the underlying physiological processes at the central nervous system level remain largely unknown. We suggest that the stimulation effects include changes in resting-state functional connectivity and in task-related cortex activation. Methods Twenty-three healthy volunteers were enrolled and divided into two groups based on the treatment received: either stimulation in the Vojta right heel zone (Group A, n = 14, 3 males, mean age 25.57) or sham stimulation of the right ankle (Group B, n = 9, no males, mean age 25). All subjects underwent a single magnetic resonance imaging (MRI) examination using our Siemens Avanto or Symphony 1.5T scanners, including 6 functional imaging experimental runs: two pairs of 6-min resting and finger tapping runs separated by two consecutive 10-min runs during intermittent pressure stimulation which was applied in 30-s blocks alternating with rest. The BOLD signal acquisition covered the whole brain in 30 axial slices using gradient-echo EPI sequence with TR 2500 ms. Statistical analysis of the imaging data was carried out using FEAT (General Linear Model, GLM), MELODIC (Independent Component Analysis, ICA), and Dual Regression tools, parts of FSL 5.0 developed by FMRIB. Group post hoc contrasts yielded Z-statistical maps thresholded using cluster significance threshold at p Results The finger tapping data showed significant interaction in the right (ipsilateral to the active extremity) middle and superior frontal gyrus, whereas the GLM analysis of the stimulation data showed stronger activation in predominantly right frontal perisylvian and insular cortex, bilateral basal ganglia, thalami, cerebellum, and brain stem in Group A, while there was stronger activation in bilateral precentral and postcentral gyri, left frontal cortex, and bilateral occipital cortices in Group B. The group ICA of both stimulation and resting data did not reveal any significant relationship between the tested variables. Conclusion Our findings during the stimulation and the voluntary motor task performance prior and after the treatment provide the evidence, that the reflex locomotion elicited by Vojta therapy is associated with specific changes in cortical and subcortical brain activation when compared to the sham treatment. Acknowledgement Supported by Grant IGA MH CR NT13575.