Recovered grasping performance after stroke depends on interhemispheric frontoparietal connectivity

Author:

Hensel Lukas1ORCID,Lange Fabian1,Tscherpel Caroline12,Viswanathan Shivakumar2,Freytag Jana1,Volz Lukas J1ORCID,Eickhoff Simon B34,Fink Gereon R12,Grefkes Christian12

Affiliation:

1. Faculty of Medicine and University Hospital Cologne, Department of Neurology, University of Cologne , Cologne , Germany

2. Cognitive Neuroscience, Institute of Neuroscience and Medicine (INM-3), Research Centre Jülich , Jülich , Germany

3. Institute of Systems Neuroscience, Medical Faculty, Heinrich Heine University Düsseldorf , Düsseldorf , Germany

4. Institute of Neuroscience and Medicine, Brain & Behaviour (INM-7), Research Centre Jülich , Jülich , Germany

Abstract

Abstract Activity changes in the ipsi- and contralesional parietal cortex and abnormal interhemispheric connectivity between these regions are commonly observed after stroke, however, their significance for motor recovery remains poorly understood. We here assessed the contribution of ipsilesional and contralesional anterior intraparietal cortex (aIPS) for hand motor function in 18 recovered chronic stroke patients and 18 healthy control subjects using a multimodal assessment consisting of resting-state functional MRI, motor task functional MRI, online-repetitive transcranial magnetic stimulation (rTMS) interference, and 3D movement kinematics. Effects were compared against two control stimulation sites, i.e. contralesional M1 and a sham stimulation condition. We found that patients with good motor outcome compared to patients with more substantial residual deficits featured increased resting-state connectivity between ipsilesional aIPS and contralesional aIPS as well as between ipsilesional aIPS and dorsal premotor cortex. Moreover, interhemispheric connectivity between ipsilesional M1 and contralesional M1 as well as ipsilesional aIPS and contralesional M1 correlated with better motor performance across tasks. TMS interference at individual aIPS and M1 coordinates led to differential effects depending on the motor task that was tested, i.e. index finger-tapping, rapid pointing movements, or a reach-grasp-lift task. Interfering with contralesional aIPS deteriorated the accuracy of grasping, especially in patients featuring higher connectivity between ipsi- and contralesional aIPS. In contrast, interference with the contralesional M1 led to impaired grasping speed in patients featuring higher connectivity between bilateral M1. These findings suggest differential roles of contralesional M1 and aIPS for distinct aspects of recovered hand motor function, depending on the reorganization of interhemispheric connectivity.

Funder

DFG

Publisher

Oxford University Press (OUP)

Subject

Neurology (clinical)

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