Involvement of excitatory-inhibitory balance on upper limb motor recovery after stroke

2022 Fiscal Year Final Research Report

• Project/Area Number: 20K19393
• Research Category: Grant-in-Aid for Early-Career Scientists
• Allocation Type: Multi-year Fund
• Review Section: Basic Section 59010:Rehabilitation science-related
• Research Institution: Fujita Health University
• Principal Investigator: Uehara Shintaro 藤田医科大学, 保健学研究科, 講師 (30725130)
• Project Period (FY): 2020-04-01 – 2023-03-31
• Keywords: 運動 / 脳卒中 / 上肢 / 到達運動 / 経頭蓋磁気刺激 / 機能回復

Outline of Final Research Achievements

The present study aimed to investigate the neural mechanisms underlying upper limb motor dysfunction after stroke and its recovery using transcranial magnetic stimulation, one of the non-invasive brain stimulation techniques. We first analyzed the performance of goal-directed horizontal reaching in post-stroke patients to quantify motor function and its improvement. For patients with mild hemiparesis, some kinematic parameters derived from the trajectory of the hand were suggested to reflect motor function and its recovery. In addition, for patients with moderate-to-severe hemiparesis, the total amount of displacement of hand position during reaching attempts may be a proxy for them. Electrophysiological studies showed that a peripheral index, rather than those in the primary motor cortex, may be more associated with upper limb motor impairment and function.

Free Research Field

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Academic Significance and Societal Importance of the Research Achievements

脳卒中発症後に見られる上肢の運動麻痺とそれに起因する運動機能障害は、多くの患者で後遺障害として残存し、日常生活活動や社会復帰を妨げる要因の一つになっている。しかしながら、上肢運動機能障害とその回復過程に関する機序は未だ十分には明らかにはされていない。本研究はまず、上肢の運動機能およびその回復を定量化するための指標を示した。さらに、運動機能と関係する電気生理学的指標を示した。これらの成果は、今後の統合的な縦断的分析を進めるための足掛かりとして位置付けることができる。