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Rehabilitation in chronic spatial neglect strengthens resting-state connectivity
Umeå University, Faculty of Medicine, Department of Radiation Sciences. Umeå University, Faculty of Medicine, Umeå Centre for Functional Brain Imaging (UFBI).ORCID iD: 0000-0001-6784-1945
Umeå University, Faculty of Medicine, Department of Pharmacology and Clinical Neuroscience.ORCID iD: 0000-0003-1650-8856
Umeå University, Faculty of Medicine, Department of Integrative Medical Biology (IMB). Umeå University, Faculty of Medicine, Umeå Centre for Functional Brain Imaging (UFBI). Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Stockholm, Sweden.ORCID iD: 0000-0003-3926-8656
Umeå University, Faculty of Medicine, Department of Pharmacology and Clinical Neuroscience.
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2019 (English)In: Acta Neurologica Scandinavica, ISSN 0001-6314, E-ISSN 1600-0404, Vol. 139, no 3, p. 254-259Article in journal (Refereed) Published
Abstract [en]

Objectives: Rehabilitation of patients with chronic visuospatial neglect is underexplored, and little is known about neural mechanisms that can be exploited to promote recovery. In this study, we present data on resting-state functional connectivity within the dorsal attention network (DAN) in chronic neglect patients as they underwent training in a virtual reality (VR) environment that improved left-side awareness.

Methods: The study included 13 patients with visuospatial neglect persisting more than six months after a right-sided stroke. The patients underwent resting-state functional magnetic resonance imaging (fMRI). Scans were collected at baseline and after five weeks of intense training. We specifically examined resting-state functional connectivity within the DAN. In addition, using spatial concordance correlation, we compared changes in the spatial topology of the DAN with that of other networks.

Results: We found a longitudinal increase in interhemispheric functional connectivity between the right frontal eye field and the left intraparietal sulcus following training (before: 0.33 +/- 0.17 [mean +/- SD]; after: 0.45 +/- 0.13; P = 0.004). The spatial concordance analyses indicated that training influenced the DAN connectivity more than any of the other networks.

Conclusion: Intense VR training that improved left-sided awareness in chronic stroke patients also increased sporadic interhemispheric functional connectivity within the DAN. Specifically, a region responsible for saccadic eye movement to the left became more integrated with the left posterior parietal cortex. These results highlight a mechanism that should be exploited in the training of patients with chronic visuospatial neglect.

Place, publisher, year, edition, pages
John Wiley & Sons, 2019. Vol. 139, no 3, p. 254-259
Keywords [en]
cognitive rehabilitation, functional magnetic resonance imaging, neuronal plasticity, spatial neglect, virtual reality
National Category
Neurology
Identifiers
URN: urn:nbn:se:umu:diva-156864DOI: 10.1111/ane.13048ISI: 000458682700006PubMedID: 30427058OAI: oai:DiVA.org:umu-156864DiVA, id: diva2:1296026
Available from: 2019-03-13 Created: 2019-03-13 Last updated: 2019-03-13Bibliographically approved

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Wåhlin, AndersFordell, HelenaEkman, UrbanLenfeldt, NiklasMalm, Jan
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Department of Radiation SciencesUmeå Centre for Functional Brain Imaging (UFBI)Department of Pharmacology and Clinical NeuroscienceDepartment of Integrative Medical Biology (IMB)
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