Neural Regeneration Research ›› 2023, Vol. 18 ›› Issue (2): 410-415.doi: 10.4103/1673-5374.344832

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Modified constraint-induced movement therapy enhances cortical plasticity in a rat model of traumatic brain injury: a resting-state functional MRI study

Cheng-Cheng Sun1, #, Yu-Wen Zhang2, #, Xiang-Xin Xing3, 4, 5, #, Qi Yang1, Ling-Yun Cao4, Yu-Feng Cheng4, Jing-Wang Zhao4, Shao-Ting Zhou6, Dan-Dan Cheng7, Ye Zhang8, Xu-Yun Hua3, 9, 10, *, He Wang2, 11, 12, *, Dong-Sheng Xu3, 4, 5, *   

  1. 1Department of Rehabilitation, Tongji Hospital, School of Medicine, Tongji University, Shanghai, China; 2Institute of Science and Technology for Brain-Inspired Intelligence, Fudan University, Shanghai, China; 3Center of Rehabilitation Medicine, Yueyang Hospital of Integrated Traditional Chinese and Western Medicine, Shanghai, China; 4Institute of Rehabilitation Medicine, School of Rehabilitation Science, Shanghai University of Traditional Chinese Medicine, Shanghai, China; 5Engineering Research Center of Traditional Chinese Medicine Intelligent Rehabilitation, Ministry of Education, Shanghai, China; 6Department of Rehabilitation, Shanghai East Hospital, School of Medicine, Tongji University, Shanghai, China; 7Department of Rehabilitation, Tongren Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China; 8Department of Rehabilitation, Shanghai Jiao Tong University Affiliated Sixth People’s Hospital, Shanghai, China; 9Department of Traumatology and Orthopedics, Yueyang Hospital, Shanghai University of Traditional Chinese Medicine, Shanghai, China; 10Department of Rehabilitation, Yangzhi Rehabilitation Hospital, Tongji University, Shanghai, China; 11Human Phenome Institute, Fudan University, Shanghai, China; 12Key Laboratory of Computational Neuroscience and Brain-Inspired Intelligence (Fudan University), Ministry of Education, Shanghai, China
  • Online:2023-02-15 Published:2022-08-09
  • Contact: Dong-Sheng Xu, MD, dxu0927@shutcm.edu.cn; He Wang, PhD, hewang@fudan.edu.cn; Xu-Yun Hua, MD, PhD, swrhxy@126.com.
  • Supported by:
    This project was supported by the National Key R&D Program of China, Nos. 2020YFC2004202 (to DSX), 2018YFC2001600 (to XYH); the National Natural Science Foundation of China, Nos. 81974358 (to DSX), 81802249 (to XYH) and 82172554 (to XYH).

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Abstract: Modified constraint-induced movement therapy (mCIMT) has shown beneficial effects on motor function improvement after brain injury, but the exact mechanism remains unclear. In this study, amplitude of low frequency fluctuation (ALFF) metrics measured by resting-state functional magnetic resonance imaging was obtained to investigate the efficacy and mechanism of mCIMT in a control cortical impact (CCI) rat model simulating traumatic brain injury. At 3 days after control cortical impact model establishment, we found that the mean ALFF (mALFF) signals were decreased in the left motor cortex, somatosensory cortex, insula cortex and the right motor cortex, and were increased in the right corpus callosum. After 3 weeks of an 8-hour daily mCIMT treatment, the mALFF values were significantly increased in the bilateral hemispheres compared with those at 3 days postoperatively. The mALFF signal values of left corpus callosum, left somatosensory cortex, right medial prefrontal cortex, right motor cortex, left postero dorsal hippocampus, left motor cortex, right corpus callosum, and right somatosensory cortex were increased in the mCIMT group compared with the control cortical impact group. Finally, we identified brain regions with significantly decreased mALFF values at 3 days postoperatively. Pearson correlation coefficients with the right forelimb sliding score indicated that the improvement in motor function of the affected upper limb was associated with an increase in mALFF values in these brain regions. Our findings suggest that functional cortical plasticity changes after brain injury, and that mCIMT is an effective method to improve affected upper limb motor function by promoting bilateral hemispheric cortical remodeling. mALFF values correlate with behavioral changes and can potentially be used as biomarkers to assess dynamic cortical plasticity after traumatic brain injury.

Key words: amplitude of low frequency fluctuation, cortical plasticity, functional magnetic resonance imaging, modified constraint-induced movement therapy, traumatic brain injury