Functional magnetic resonance brain imaging of imagined walking to study locomotor function after stroke. Issue 1 (January 2021)

• Record Type: Journal Article
• Authors: Boyne, Pierce; Doren, Sarah; Scholl, Victoria; Staggs, Emily; Whitesel, Dustyn; Maloney, Thomas; Awosika, Oluwole; Kissela, Brett; Dunning, Kari; Vannest, Jennifer
• Is Part Of: Clinical neurophysiology. Volume 132:Issue 1(2021)
• Page Start: 167
• Page End: 177
• Publication Date: 2021-01
• Subjects: Locomotion -- Gait -- Imagery -- Brain -- Magnetic resonance imaging; CIFTI connectivity informatics technology initiative -- CLR cerebellar locomotor region -- ECG electrocardiogram -- fMRI functional magnetic resonance imaging -- FSL functional MRI of the brain software library -- ICA-AROMA independent components analysis based automatic removal of motion artifacts -- MLR midbrain locomotor region -- M1-LL primary motor cortex lower limb region -- pvCblm paravermal cerebellum area VI -- ROI region of interest -- SFG9m superior frontal gyrus medial area 9 -- T1w T1-weighted MRI -- wCMT-LL weighted corticofugal motor tract lesion load; Neurophysiology -- Periodicals; Electroencephalography -- Periodicals; Electromyography -- Periodicals; Neurology -- Periodicals; 612.8
• DOI: 10.1016/j.clinph.2020.11.009
• Languages: English
• ISSNs: 1388-2457

Abstract

Highlights: Imagined walking evokes greater overall brain activation in stroke survivors vs. controls, likely revealing compensatory changes. Greater activation during imagined walking is associated with worse gait function, raising the possibility of maladaptation. Compared with unilateral knee extension, imagined walking shows reverse associations with stroke and gait function. Abstract: Objective: Imagined walking has yielded insights into normal locomotor control and could improve understanding of neurologic gait dysfunction. This study evaluated brain activation during imagined walking in chronic stroke. Methods: Ten persons with stroke and 10 matched controls completed a walking test battery and a magnetic resonance imaging session including imagined walking and knee extension tasks. Brain activations were compared between tasks and groups. Associations between activations and composite gait score were also calculated, while controlling for lesion load. Results: Stroke and worse gait score were each associated with lesser overall brain activation during knee extension but greater overall activation during imagined walking. During imagined walking, the stroke group significantly activated the primary motor cortex lower limb region and cerebellar locomotor region. Better walking function was associated with less activation of these regions and greater activation of medial superior frontal gyrus area 9. Conclusions: Compared with knee extension, imagined walking was less sensitive to stroke-related deficits in brain activation but better at revealing compensatory changes, some of which could be maladaptive. Significance: The identified associations for imagined walking suggest potential neural mechanisms of locomotor adaptation after stroke, which could be useful for future intervention development and prognostication.