Can fMRI Measures of Brain Motor Activation Add Significantly to Other Variables in the Prediction of Treatment Response?

Abstract

See related article, pages 2108–2114. This study is among the first to address the basic question of whether fMRI measures of brain motor activation can add significantly to other variables in the prediction of treatment response. The study attempts to use baseline variables in a cohort of 24 chronic stroke patients to predict response to a specific form of rehabilitation, 6 weeks of rehabilitation therapy that targeted arm motor function, especially distally. Patients were also randomized and either did or did not undergo motor cortex electrical stimulation, but the evaluation of this treatment was not the purpose of this study. This work presents evidence of the use of fMRI as a useful tool to help predicting the responsiveness to an intervention aimed to improve arm motor function. It applies to patients able to mobilize the hand (active wrist extension of at least 5 degrees) and a measurable activation in the ipsilesional primary motor cortex (iM1). It is examining whether fMRI data can predict outcome, but crucially whether it can predict outcome over and above other scores. Only 2 variables out of 13 remain at the end of the analyses: degree of hand …