RESEARCH ARTICLE


Functional MRI of Rehabilitation in Chronic Stroke Patients Using Novel MR-Compatible Hand Robots



Dionyssios Mintzopoulos1, 2, Azadeh Khanicheh3, Angelos A Konstas1, 2, Loukas G Astrakas1, 2, Aneesh B Singhal2, 4, Michael A Moskowitz2, 5, Bruce R Rosen2, A. Aria Tzika*, 1, 2
1 NMR Surgical Laboratory, Department of Surgery, Massachusetts General Hospital and Shriner’s Burn Institute, Harvard Medical School, Boston, MA 02114, USA
2 Athinoula A. Martinos Center for Biomedical Imaging, Department of Radiology, Massachusetts General Hospital, Harvard Medical School, Charlestown, MA 02129, USA
3 Department of Mechanical and Industrial Engineering, Northeastern University, Boston, MA 02115, USA
4 Department of Neurology, Massachusetts General Hospital Stroke Research Center, Harvard Medical School, Boston, MA 02114, USA
5 Neuroscience Center, Departments of Neurology and Neurosurgery, Massachusetts General Hospital, Harvard Medical School, Charlestown, MA 02129, USA


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© Mintzopoulos et al; Licensee Bentham Open

open-access license: This is an open access article licensed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted, non-commercial use, distribution and reproduction in any medium, provided the work is properly cited.

* Address correspondence to this author at the NMR Surgical Laboratory, Department of Surgery, Massachusetts General Hospital and Shriner’s Burn Institute, Harvard Medical School, Boston, MA 02114, USA; E-mail: atzika@hms.harvard.edu


Abstract

We monitored brain activation after chronic stroke by combining functional magnetic resonance imaging (fMRI) with a novel MR-compatible, hand-induced, robotic device (MR_CHIROD). We evaluated 60 fMRI datasets on a 3 T MR system from five right-handed patients with left-sided stroke ≥6 months prior and mild to moderate hemiparesis. Patients trained the paretic right hand at approximately 75% of maximum strength with an exercise ball for 1 hour/day, 3 days/week for 4 weeks. Multi-level fMRI data were acquired before, during training, upon completion of training, and after a non-training period using parallel imaging employing GeneRalized Autocalibrating Partially Parallel Acquisitions (GRAPPA) while the participant used the MR_CHIROD. Training increased the number of activated sensorimotor cortical voxels, indicating functional cortical plasticity in chronic stroke patients. The effect persisted four weeks after training completion, indicating the potential of rehabilitation in inducing cortical plasticity in chronic stroke patients.

Keywords: Functional Magnetic Resonance Imaging (fMRI), brain, stroke, rehabilitation.