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Previous issue date: 2012-08-24 / Coordena??o de Aperfei?oamento de Pessoal de N?vel Superior / Mirror therapy (MT) is being used as a rehabilitation tool in various diseases, including
stroke. Although some studies have shown its effectiveness, little is known about neural
mechanisms that underlie the rehabilitation process. Therefore, this study aimed at
assessing cortical neuromodulation after a single MT intervention in ischemic stroke
survivors, by means of by functional Magnetic Resonance Imaging (fMRI) and
Transcranial Magnetic Stimulation (TMS). Fifteen patients participated in a single thirty
minutes MT session. fMRI data was analyzed bilaterally in the following Regions of
Interest (ROI): Supplementary Motor Area (SMA), Premotor cortex (PMC), Primary
Motor cortex (M1), Primary Sensory cortex (S1) and Cerebellum. In each ROI, changes
in the percentage of occupation and beta values were computed. Group fMRI data
showed a significant decreased in the percentage of occupation in PMC and cerebellum,
contralateral to the affected hand (p <0.05). Significant increase in beta values was
observed in the following contralateral motor areas: SMA, Cerebellum, PMC and M1
(p<0,005). Moreover, a significant decrease was observed in the following ipsilateral
motor areas: PMC and M1 (p <0,001). In S1 a bilateral significant decrease (p<0.0005)
was observed.TMS consisted of the analysis of Motor Evoked Potential (MEP) of M1
hotspot. A significant increase in the amplitude of the MEP was observed after therapy
in the group (p<0,0001) and individually in 4 patients (p <0.05). Altogether, our results
imply that single MT intervention is already capable of promoting changes in
neurobiological markers toward patterns observed in healthy subjects. Furthermore, the
contralateral hemisphere motor areas changes are opposite to the ones in the ipsilateral
side, suggesting an increase system homeostasis. / A Terapia Espelho (TE) vem sendo usada como ferramenta de reabilita??o para v?rias
doen?as, incluindo o Acidente Vascular Cerebral (AVC). Embora alguns estudos
tenham mostrado sua efic?cia cl?nica, pouco se sabe sobre os mecanismos neurais que
levam ? melhora observada. Desse modo, este estudo teve como objetivo avaliar a
neuromodula??o cortical promovida pela interven??o ?nica da TE em pacientes
acometidos por AVC, por meio da Resson?ncia Magn?tica funcional (fMRI, do ingl?s
Functional Magnetic Resonance Imaging) e da Estimula??o Magn?tica Transcraniana
(TMS, do ingl?s Transcranial Magnetic Stimulation). Quinze pacientes participaram de
sess?o ?nica de trinta minutos de TE. Os dados de fMRI foram analisados nas seguintes
regi?es de interesse (ROI), bilateralmente: ?rea Motora Suplementar (AMS), c?rtex
pr?-motor (PM), c?rtex motor prim?rio (M1), c?rtex sensorial prim?rio (S1) e Cerebelo.
Em cada ROI, as mudan?as na porcentagem de ocupa??o e os valores de beta foram
avaliados. Os resultados revelaram redu??o significativa no percentual de ocupa??o no
PM e cerebelo contralateral ? m?o afetada (p <0,05). Al?m disso, foi observado
aumento significativo nos valores de beta nas seguintes ?reas motoras contralaterais:
AMS, Cerebelo, PM e M1 (p <0,005) e diminui??o significativa nas seguintes ?reas
motoras ipsilaterais: PM e M1 (p < 0,001). Nas ?reas sensoriais foi observada redu??o
em S1 bilateralmente (p <0,0005). Pela TMS foi analisado o Potencial Evocado Motor
(PEM) sobre o hot spot de M1. Aumento significativo na amplitude do PEM foi
observado ap?s a terapia no grupo (p<0,0001), e individualmente em 4 pacientes (p
<0,05). Assim, nossos resultados indicam que interven??o ?nica da TE muda
marcadores neurobiol?gicos em dire??o ao padr?o observado em indiv?duos saud?veis.
Al?m disso, as altera??es nas ?reas motoras do hemisf?rio contralateral s?o opostas as
do lado ipsilateral, sugerindo um aumento na homeostase do sistema.
| Identifer | oai:union.ndltd.org:IBICT/oai:repositorio.ufrn.br:123456789/17021 |
| Date | 24 August 2012 |
| Creators | Novaes, Morgana Menezes |
| Contributors | CPF:50554310163, http://lattes.cnpq.br/7818012155694188, Santos, Ant?nio Carlos dos, CPF:39666832534, http://lattes.cnpq.br/8227933586403761, Vargas, Cl?udia Domingues, CPF:52611108668, http://lattes.cnpq.br/1019505555117852, Ara?jo, Dr?ulio Barros de |
| Publisher | Universidade Federal do Rio Grande do Norte, Programa de P?s-Gradua??o em Neurociencias, UFRN, BR, Neurobiologia Celular e Molecular; Neurobiologia de Sistemas e Cogni??o; Neurocomputa??o Neuroengen |
| Source Sets | IBICT Brazilian ETDs |
| Language | Portuguese |
| Detected Language | English |
| Type | info:eu-repo/semantics/publishedVersion, info:eu-repo/semantics/masterThesis |
| Format | application/pdf |
| Source | reponame:Repositório Institucional da UFRN, instname:Universidade Federal do Rio Grande do Norte, instacron:UFRN |
| Rights | info:eu-repo/semantics/openAccess |
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