Abstract

In this study functional Magnetic Resonance Imaging (fMRI) was used to evaluate cortical motor network adaptation after a rehabilitation program for upper extremity motor function in chronic stroke patients. Patients and healthy controls were imaged when they attempted to perform shoulder-elbow and wrist-hand movements in a 1.5 T Siemens scanner. We perform fMRI analysis at both single- and group-subject levels. Activated voxel counts are calculated to quantify brain activation in regions of interest. We discuss several candidate regression models for making inference on the count data, and propose an application of a generalized negative-binomial model (GNBM) with structured dispersion in the study. The effects of inappropriate statistical models that ignore the nature of data are addressed through Monte Carlo simulations. Based on the GNBM, significant activation differences are observed in a number of cortical regions for stroke versus control and as a result of treatment; notably, these differences are not detected when the data are analyzed using a conventional linear regression model. Our findings provide an improved functional neuroimaging data analysis protocol, specifically for pixel/voxel counts.

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