Enriched rehabilitation on brain functional connectivity in patients with post-stroke cognitive impairment
ObjectiveThis study aims to observe the effect of enrichment rehabilitation (ER) on cognitive function in post-stroke patients and to clarify its underlying mechanism.MethodsForty patients with post-stroke cognitive impairment (PSCI) meeting the inclusion criteria were randomly assigned to two group...
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| Language: | English |
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Frontiers Media S.A.
2025-01-01
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| Series: | Frontiers in Neurology |
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| Online Access: | https://www.frontiersin.org/articles/10.3389/fneur.2024.1503737/full |
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| author | Yaping Huai Weiwei Yang Yichen Lv Kui Wang Hongyu Zhou Yiqing Lu Xiaoyun Zhang Yaze Wang Jibing Wang Xin Wang |
| author_facet | Yaping Huai Weiwei Yang Yichen Lv Kui Wang Hongyu Zhou Yiqing Lu Xiaoyun Zhang Yaze Wang Jibing Wang Xin Wang |
| author_sort | Yaping Huai |
| collection | DOAJ |
| description | ObjectiveThis study aims to observe the effect of enrichment rehabilitation (ER) on cognitive function in post-stroke patients and to clarify its underlying mechanism.MethodsForty patients with post-stroke cognitive impairment (PSCI) meeting the inclusion criteria were randomly assigned to two groups: conventional medical rehabilitation (CM group) and ER intervention (ER group). All patients underwent assessments of overall cognitive function, attention function, and executive function within 24 h before the start of training and within 24 h after the 8 weeks of training. We investigated the altered resting-state functional connectivity (RSFC) with the right dorsolateral prefrontal cortex (DLPFC) in patients with PSCI following ER training through functional magnetic resonance imaging (fMRI). Additionally, twenty people undergoing routine physical examinations in the outpatient department of our hospital were selected as the healthy control (HC) group.ResultsBefore training, both groups of PSCI patients exhibited significant impairment in overall cognitive function, attention function, and executive function compared to the HC group. However, there was no significant difference between the two PSCI patient groups. Following 8 weeks of treatment, both PSCI patient groups demonstrated substantial improvement in overall cognitive function, attention function, and executive function. Moreover, the ER group exhibited greater improvement after training compared to the CM group. Despite the improvements, the cognitive behavioral performance assessment scores of both PSCI patient groups remained lower than those of the HC group. RSFC analysis in the ER group revealed strengthened positive functional connectivity between the right DLPFC and the left superior frontal gyrus (SFG) and left anterior cingulate gyrus (ACG), along with decreased functional connectivity between the right DLPFC and the right superior temporal gyrus (STG) and right precentral gyrus post-ER intervention.ConclusionER intervention is more effective than conventional medical rehabilitation in improving the cognitive function of PSCI patients, potentially by augmenting the FC between the right DLPFC and dominant cognitive brain regions, such as the left SFG and left ACG while attenuating the FC between the right DLPFC and non-dominant hemisphere areas including the STG and precentral gyrus within the right hemisphere. |
| format | Article |
| id | doaj-art-ad832e234c754c1c9d8bf3398a99d12a |
| institution | Kabale University |
| issn | 1664-2295 |
| language | English |
| publishDate | 2025-01-01 |
| publisher | Frontiers Media S.A. |
| record_format | Article |
| series | Frontiers in Neurology |
| spelling | doaj-art-ad832e234c754c1c9d8bf3398a99d12a2025-01-07T05:24:13ZengFrontiers Media S.A.Frontiers in Neurology1664-22952025-01-011510.3389/fneur.2024.15037371503737Enriched rehabilitation on brain functional connectivity in patients with post-stroke cognitive impairmentYaping Huai0Weiwei Yang1Yichen Lv2Kui Wang3Hongyu Zhou4Yiqing Lu5Xiaoyun Zhang6Yaze Wang7Jibing Wang8Xin Wang9Department of Rehabilitation Medicine, Shenzhen Longhua District Central Hospital, Shenzhen, Guangdong, ChinaDepartment of Rehabilitation Medicine, Shenzhen Longhua District Central Hospital, Shenzhen, Guangdong, ChinaDepartment of Rehabilitation Medicine, Northern Jiangsu People's Hospital, Yangzhou, ChinaDepartment of Rehabilitation Medicine, Northern Jiangsu People's Hospital, Yangzhou, ChinaDepartment of Rehabilitation Medicine, Northern Jiangsu People's Hospital, Yangzhou, ChinaDepartment of Rehabilitation Medicine, Shenzhen Longhua District Central Hospital, Shenzhen, Guangdong, ChinaDepartment of Rehabilitation Medicine, Shenzhen Longhua District Central Hospital, Shenzhen, Guangdong, ChinaDepartment of Rehabilitation Medicine, Shenzhen Longhua District Central Hospital, Shenzhen, Guangdong, ChinaDepartment of Rehabilitation Medicine, Northern Jiangsu People's Hospital, Yangzhou, ChinaDepartment of Rehabilitation Medicine, Northern Jiangsu People's Hospital, Yangzhou, ChinaObjectiveThis study aims to observe the effect of enrichment rehabilitation (ER) on cognitive function in post-stroke patients and to clarify its underlying mechanism.MethodsForty patients with post-stroke cognitive impairment (PSCI) meeting the inclusion criteria were randomly assigned to two groups: conventional medical rehabilitation (CM group) and ER intervention (ER group). All patients underwent assessments of overall cognitive function, attention function, and executive function within 24 h before the start of training and within 24 h after the 8 weeks of training. We investigated the altered resting-state functional connectivity (RSFC) with the right dorsolateral prefrontal cortex (DLPFC) in patients with PSCI following ER training through functional magnetic resonance imaging (fMRI). Additionally, twenty people undergoing routine physical examinations in the outpatient department of our hospital were selected as the healthy control (HC) group.ResultsBefore training, both groups of PSCI patients exhibited significant impairment in overall cognitive function, attention function, and executive function compared to the HC group. However, there was no significant difference between the two PSCI patient groups. Following 8 weeks of treatment, both PSCI patient groups demonstrated substantial improvement in overall cognitive function, attention function, and executive function. Moreover, the ER group exhibited greater improvement after training compared to the CM group. Despite the improvements, the cognitive behavioral performance assessment scores of both PSCI patient groups remained lower than those of the HC group. RSFC analysis in the ER group revealed strengthened positive functional connectivity between the right DLPFC and the left superior frontal gyrus (SFG) and left anterior cingulate gyrus (ACG), along with decreased functional connectivity between the right DLPFC and the right superior temporal gyrus (STG) and right precentral gyrus post-ER intervention.ConclusionER intervention is more effective than conventional medical rehabilitation in improving the cognitive function of PSCI patients, potentially by augmenting the FC between the right DLPFC and dominant cognitive brain regions, such as the left SFG and left ACG while attenuating the FC between the right DLPFC and non-dominant hemisphere areas including the STG and precentral gyrus within the right hemisphere.https://www.frontiersin.org/articles/10.3389/fneur.2024.1503737/fullenriched rehabilitationpost-stroke cognitive impairmentdorsolateral prefrontal cortexfunctional connectivitydominant hemisphere |
| spellingShingle | Yaping Huai Weiwei Yang Yichen Lv Kui Wang Hongyu Zhou Yiqing Lu Xiaoyun Zhang Yaze Wang Jibing Wang Xin Wang Enriched rehabilitation on brain functional connectivity in patients with post-stroke cognitive impairment Frontiers in Neurology enriched rehabilitation post-stroke cognitive impairment dorsolateral prefrontal cortex functional connectivity dominant hemisphere |
| title | Enriched rehabilitation on brain functional connectivity in patients with post-stroke cognitive impairment |
| title_full | Enriched rehabilitation on brain functional connectivity in patients with post-stroke cognitive impairment |
| title_fullStr | Enriched rehabilitation on brain functional connectivity in patients with post-stroke cognitive impairment |
| title_full_unstemmed | Enriched rehabilitation on brain functional connectivity in patients with post-stroke cognitive impairment |
| title_short | Enriched rehabilitation on brain functional connectivity in patients with post-stroke cognitive impairment |
| title_sort | enriched rehabilitation on brain functional connectivity in patients with post stroke cognitive impairment |
| topic | enriched rehabilitation post-stroke cognitive impairment dorsolateral prefrontal cortex functional connectivity dominant hemisphere |
| url | https://www.frontiersin.org/articles/10.3389/fneur.2024.1503737/full |
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