Abstract
Stroke impairments often present as cognitive and motor deficits, leading to a decline in quality of life. Recovery strategy and mechanisms, such as neuroplasticity, are important factors, as these can help improve the effectiveness of rehabilitation. The present study investigated chiropractic spinal manipulation (SM) and its effects on resting-state functional connectivity in 24 subacute to chronic stroke patients monitored by electroencephalography (EEG). Functional connectivity of both linear and non-linear coupling was estimated by coherence and phase lag index (PLI), respectively. Non-parametric cluster-based permutation tests were used to assess the statistical significance of the changes in functional connectivity following SM. Results showed a significant increase in functional connectivity from the PLI metric in the alpha band within the default mode network (DMN). The functional connectivity between the posterior cingulate cortex and parahippocampal regions increased following SM, t (23) = 10.45, p = 0.005. No significant changes occurred following the sham control procedure. These findings suggest that SM may alter functional connectivity in the brain of stroke patients and highlights the potential of EEG for monitoring neuroplastic changes following SM. Furthermore, the altered connectivity was observed between areas which may be affected by factors such as decreased pain perception, episodic memory, navigation, and space representation in the brain. However, these factors were not directly monitored in this study. Therefore, further research is needed to elucidate the underlying mechanisms and clinical significance of the observed changes.
Highlights
Stroke is a common problem affecting people worldwide and it is the number one cause of chronic disability [1]
For functional connectivity calculated from phase lag index (PLI), an increased functional connectivity within the default mode network (DMN) was observed in the spinal manipulation (SM) session in a number of brain regions, forming clusters in the non-parametric cluster-based permutation test, from pre- to post-recordings, whereas no significant changes were observed in the control session
The aim of this study was to explore the effects of chiropractic SM on resting-state EEG functional brain connectivity in subacute and chronic stroke patients
Summary
Stroke is a common problem affecting people worldwide and it is the number one cause of chronic disability [1]. The disabilities that stroke survivors experience are often chronic and can present as both impaired cognitive and motor function [2]. Rehabilitation of stroke patients, especially in the early stages after the acute phase, is of great importance, as mechanisms like neuroplasticity play a major role in the recovery, as the brain reorganizes and adapts to the lesion that the stroke has. Rehabilitation methods applied during the early stages of recovery have been shown to improve the chances of a successful recovery [4]. Research suggests that SM alters mechanoreceptive input from the spine and that this in turn alters the way in which the brain processes, interprets, and integrates other interoceptive and exteroceptive information [5]
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