ID 260 – Cortical plasticity changes induced by the use of multimodal exoskeleton complex in poststroke patients

Abstract

Objective To evaluate cortical plasticity processes induced by neurorehabilitation procedures and use of multimodal exoskeleton complex Methods 14 chronic stroke patients (mean age 57.5 ± 18.1 years, mean postsroke time 14.2 ± 9.9 months) were included. All patients trained 5 times per week for 2 weeks on multimodal exoskeleton complex and standardized physical therapy. Cortical plasticity processes were evaluated before and after trains by functional magnetic resonance imaging (fMRI) and navigated transcranial magnetic stimulation (nTMS). For fMRI we developed paradigm simulated reference load when walking. nTMS was performed for mapping leg cortical area. We evaluate rest motor threshold (RMT) and area’s squares for both tibialis anterior muscles. For clinical assessment we use a Fugl-Meyer Scale and 10 m walked test. Results No significant differences in clinical scales, RMT were found. Opposite directional changes in leg motor areas’ square (increase in affected hemisphere (before: 19.5 ± 22.2 mm 2 ; after: 22 ± 17.7 mm 2 ) and decreased in healthy hemisphere (before: 41.2 ± 24.9 mm 2 ; after: 39.2 ± 30.8 mm 2 ) were observed. In fMRI study the increase of activation zones in both SM1 and SMA and decrease of activation in both S2 were detected. Functional connectivity changes were founded: additional connections formation in the both hemispheres, and statistically significant interhemispheric connections between the primary motor cortex. Conclusions Founded changes in cortical plasticity can be the basics of future walking improvement.