Brain-movement relationship in upper-limb functional tasks for chronic post-stroke patients. Lien cerveau-mouvement lors du mouvement du membre supérieur chez des patients post-AVC en phase chronique

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Faity, Germain | Muller, Camille, O | Muthalib, Makii | Perrey, S. | Dray, Gérard | Xu, Binbin | Delorme, Marion | Mottet, Denis | Laffont, Isabelle | Froger, Jérôme | Bakhti, Karima

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International audience. Introduction. Post-stroke brain activations related to paretic movement and their evolution through rehabilitation is a subject of major interest (Jones, 2017). To evaluate the level of functional recovery of the upper limb (UL) after stroke, our team has developed functional motor tasks evaluating the i) use of the arm and trunk compensation during a reaching task, and ii) speed-accuracy trade-off with an index of performance (IP) in a circular steering task. Two non-invasive neuroimaging methods allow for recording the task-related brain activation: functional near-infrared spectroscopy (fNIRS) and electroencephalography (EEG) respectively based on haemodynamic response electrical activity. Associated to kinematics assessments during movement it could unveil underlying mechanisms of functional upper limb (UL) recovery. A first step to understand the post-stroke UL recovery is to observe the modification of UL movement and related brain activity due to stroke.Objective. This project aims to explore the brain and movement modification related to chronic stroke during UL functional tasks.Methods. 21 chronic post-stroke patients (64.4 ±10.2 yrs.) and 21 old healthy participants (73.1 ± 6.7 yrs.) realized two unilateral UL tasks: i) a reaching target task in spontaneous and then in trunk constrained condition and ii) a circular steering task displacing a mouse as fast as possible on a tablet within fixed boundaries of a circle projected on a screen. Hand movement and trunk compensation in both tasks were assessed using a Kinect 3D motion capture device (LSL-Kinect; 10.5281/zenodo.4300182), and motor performance was assessed during the circular steering task (LSL-Mouse; 10.5281/zenodo.4297675). A combined fNIRS-fEEG system was used to record motor cortices activations during each task.Results. Kinematics analyses showed a decreased performances in the circular steering task and an increased use of trunk compensation in post-stroke patients in both tasks. Brain analyses, showed increased activation on the reaching task for patients with paretic arm, associated to an increased use of trunk and a higher impairment (clinical score).Conclusions. This study showed stroke related effect on the task-related brain and kinematics activity during proximal unilateral UL movement that evolved full UL joints movement (i.e., shoulder, elbow, wrist). Moreover, we showed that combined fNIRS-fEEG-kinematics could be used in a rehabilitation unit to follow neuroplasticity and UL recovery evolvement. Perspectives of this project will be the exploration of the movement-related brain patterns in post-stroke patients during their rehabilitation and its potential link with functional recovery.

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