Abstract
Objective: The aim of this study is to evaluate the efficacy of Constraint-Induced Movement Therapy (CIMT) using longitudinal functional Magnetic Resonance Imaging (fMRI) to assess brain activity in a patient who recovered from right hemiparesis.
Methods and Procedures: A 58-year-old male with right hemiparesis underwent serial fMRI while performing self paced thumb-index opposition task, and evaluated motor function assessments at the day before and immediately after CIMT, and after 6-month follow-up.
Results: Motor function scores immediately improved and were maintained after CIMT at the 6-month follow-up. fMRI of the affected hand showed activation of the contralateral primary sensorimotor cortex (SM1) and supplementary motor cortex (SMA) at all scan points and the ipsilateral SM1 at the before-and after-CIMT scans. Contralateral cerebellar (CB) activity was detected in the scan obtained before CIMT, whereas bilateral activity was detected in the scan after CIMT. At the 6-month follow-up, activities in the ipsilateral SM1 and contralateral CB disappeared and there was activation of the ipsilateral CB, contralateral SM1, and SMA.
Conclusion: The results of this study indicate that activation of the ipsilateral CB was important for the achievement of good motor function and suggest that the reorganization of the functional network within the ipsilateral CB as well as the activity pattern of the motor cortex is crucial for the reacquisition of practical motor function.
