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Nashed JY, Shearer KT, Wang JZ, Chen Y, Cook EE, Champagne AA, Coverdale NS, Fernandez-Ruiz J, Striver SI, Flanagan JR, Gallivan JP, Cook DJ. Spontaneous Behavioural Recovery Following Stroke Relates to the Integrity of Parietal and Temporal Regions. Transl Stroke Res 2024; 15:127-139. [PMID: 36542292 DOI: 10.1007/s12975-022-01115-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2022] [Revised: 11/29/2022] [Accepted: 12/03/2022] [Indexed: 12/24/2022]
Abstract
Stroke is a devastating disease that results in neurological deficits and represents a leading cause of death and disability worldwide. Following a stroke, there is a degree of spontaneous recovery of function, the neural basis of which is of great interest among clinicians in their efforts to reduce disability following stroke and enhance rehabilitation. Conventionally, work on spontaneous recovery has tended to focus on the neural reorganization of motor cortical regions, with comparably little attention being paid to changes in non-motor regions and how these relate to recovery. Here we show, using structural neuroimaging in a macaque stroke model (N = 31) and by exploiting individual differences in spontaneous behavioural recovery, that the preservation of regions in the parietal and temporal cortices predict animal recovery. To characterize recovery, we performed a clustering analysis using Non-Human Primate Stroke Scale (NHPSS) scores and identified a good versus poor recovery group. By comparing the preservation of brain volumes in the two groups, we found that brain areas in integrity of brain areas in parietal, temporal and somatosensory cortex were associated with better recovery. In addition, a decoding approach performed across all subjects revealed that the preservation of specific brain regions in the parietal, somatosensory and medial frontal cortex predicted recovery. Together, these findings highlight the importance of parietal and temporal regions in spontaneous behavioural recovery.
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Affiliation(s)
- Joseph Y Nashed
- Department of Translational Medicine, Queen's University, 18 Stuart Street, Room 230, Botterell Hall, Kingston, Ontario, K7L 3N6, Canada
- Centre of Neuroscience Studies, Queen's University, Kingston, Ontario, K7L 3N6, Canada
- School of Medicine, Queen's University, Kingston, Ontario, K7L 3N6, Canada
| | - Kaden T Shearer
- Centre of Neuroscience Studies, Queen's University, Kingston, Ontario, K7L 3N6, Canada
- School of Medicine, Queen's University, Kingston, Ontario, K7L 3N6, Canada
| | - Justin Z Wang
- School of Medicine, Queen's University, Kingston, Ontario, K7L 3N6, Canada
- Division of Neurosurgery, Department of Surgery, University of Toronto, Toronto, Ontario, M5T 1P5, Canada
| | - Yining Chen
- School of Medicine, Queen's University, Kingston, Ontario, K7L 3N6, Canada
| | - Elise E Cook
- Centre of Neuroscience Studies, Queen's University, Kingston, Ontario, K7L 3N6, Canada
| | - Allen A Champagne
- School of Medicine, Queen's University, Kingston, Ontario, K7L 3N6, Canada
| | - Nicole S Coverdale
- Centre of Neuroscience Studies, Queen's University, Kingston, Ontario, K7L 3N6, Canada
| | - Juan Fernandez-Ruiz
- Departamento de Fisiología, Facultad de Medicina, Universidad Nacional Autónoma de México, Mexico City, Mexico
| | - Shirley I Striver
- Division of Neurosurgery, Department of Surgery, Queen's University, Kingston, Ontario, K7L 2V7, Canada
| | - J Randal Flanagan
- Centre of Neuroscience Studies, Queen's University, Kingston, Ontario, K7L 3N6, Canada
- Department of Psychology, Queen's University, Kingston, Ontario, K7L 3N6, Canada
| | - Jason P Gallivan
- Centre of Neuroscience Studies, Queen's University, Kingston, Ontario, K7L 3N6, Canada
- Department of Psychology, Queen's University, Kingston, Ontario, K7L 3N6, Canada
- Department of Biomedical and Molecular Sciences, Queen's University, Kingston, Ontario, K7L 3N6, Canada
| | - Douglas J Cook
- Department of Translational Medicine, Queen's University, 18 Stuart Street, Room 230, Botterell Hall, Kingston, Ontario, K7L 3N6, Canada.
- Centre of Neuroscience Studies, Queen's University, Kingston, Ontario, K7L 3N6, Canada.
- School of Medicine, Queen's University, Kingston, Ontario, K7L 3N6, Canada.
- Division of Neurosurgery, Department of Surgery, Queen's University, Kingston, Ontario, K7L 2V7, Canada.
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Lorenz EA, Su X, Skjæret-Maroni N. A review of combined functional neuroimaging and motion capture for motor rehabilitation. J Neuroeng Rehabil 2024; 21:3. [PMID: 38172799 PMCID: PMC10765727 DOI: 10.1186/s12984-023-01294-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2023] [Accepted: 12/11/2023] [Indexed: 01/05/2024] Open
Abstract
BACKGROUND Technological advancements in functional neuroimaging and motion capture have led to the development of novel methods that facilitate the diagnosis and rehabilitation of motor deficits. These advancements allow for the synchronous acquisition and analysis of complex signal streams of neurophysiological data (e.g., EEG, fNIRS) and behavioral data (e.g., motion capture). The fusion of those data streams has the potential to provide new insights into cortical mechanisms during movement, guide the development of rehabilitation practices, and become a tool for assessment and therapy in neurorehabilitation. RESEARCH OBJECTIVE This paper aims to review the existing literature on the combined use of motion capture and functional neuroimaging in motor rehabilitation. The objective is to understand the diversity and maturity of technological solutions employed and explore the clinical advantages of this multimodal approach. METHODS This paper reviews literature related to the combined use of functional neuroimaging and motion capture for motor rehabilitation following the PRISMA guidelines. Besides study and participant characteristics, technological aspects of the used systems, signal processing methods, and the nature of multimodal feature synchronization and fusion were extracted. RESULTS Out of 908 publications, 19 were included in the final review. Basic or translation studies were mainly represented and based predominantly on healthy participants or stroke patients. EEG and mechanical motion capture technologies were most used for biomechanical data acquisition, and their subsequent processing is based mainly on traditional methods. The system synchronization techniques at large were underreported. The fusion of multimodal features mainly supported the identification of movement-related cortical activity, and statistical methods were occasionally employed to examine cortico-kinematic relationships. CONCLUSION The fusion of motion capture and functional neuroimaging might offer advantages for motor rehabilitation in the future. Besides facilitating the assessment of cognitive processes in real-world settings, it could also improve rehabilitative devices' usability in clinical environments. Further, by better understanding cortico-peripheral coupling, new neuro-rehabilitation methods can be developed, such as personalized proprioceptive training. However, further research is needed to advance our knowledge of cortical-peripheral coupling, evaluate the validity and reliability of multimodal parameters, and enhance user-friendly technologies for clinical adaptation.
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Affiliation(s)
- Emanuel A Lorenz
- Department of Computer Science, Norwegian University of Science and Technology, Trondheim, Norway.
| | - Xiaomeng Su
- Department of Computer Science, Norwegian University of Science and Technology, Trondheim, Norway
| | - Nina Skjæret-Maroni
- Department of Neuromedicine and Movement Science, Norwegian University of Science and Technology, Trondheim, Norway
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Lamberti N, Manfredini F, Nardi F, Baroni A, Piva G, Crepaldi A, Basaglia N, Casetta I, Straudi S. Cortical Oxygenation during a Motor Task to Evaluate Recovery in Subacute Stroke Patients: A Study with Near-Infrared Spectroscopy. Neurol Int 2022; 14:322-335. [PMID: 35466207 PMCID: PMC9036242 DOI: 10.3390/neurolint14020026] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2021] [Revised: 03/10/2022] [Accepted: 03/21/2022] [Indexed: 11/16/2022] Open
Abstract
In subacute stroke patients we studied cortical oxygenation changes by near-infrared spectroscopy (NIRS) during a motor task performed with the hemiparetic arm (15 s of reaching and grasping, 45 s of rest, repeated 6 times). Twenty-three subjects were included at baseline, compared with six healthy subjects, and restudied after 6 weeks of rehabilitation. Motor/premotor cortical changes in oxyhemoglobin detected by NIRS were quantified as the area under the curve (AUC) for the total cortex (TOT-AUC) and for both affected (AFF-AUC) and unaffected hemispheres (UN-AUC). The ratio between AUC and the number of task repetitions performed identified the cortical metabolic cost (CMC) or the oxygenation increase for a single movement. Fugl−Meyer assessment of the upper extremity (FMA-UE) was also performed. At baseline, both total and hemispheric CMC were significantly higher in stroke patients than in healthy subjects and inversely correlated with FMA-UE. After rehabilitation, changes in total-CMC and unaffected-CMC, but not Affected-CMC, were inversely correlated with variations in the FMA-UE score. A value > 5000 a.u. for the ratio baseline TOT-CMC/days since stroke was associated with not reaching the clinically important difference for FMA-UE after rehabilitation. In subacute stroke the CMC, a biomarker assessed by NIRS during a motor task with the hemiparetic arm, may describe cortical time/treatment reorganization and favor patient selection for rehabilitation.
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Affiliation(s)
- Nicola Lamberti
- Department of Neuroscience and Rehabilitation, University of Ferrara, Via Luigi Borsari 46, 44121 Ferrara, Italy; (N.L.); (F.N.); (A.C.); (I.C.); (S.S.)
| | - Fabio Manfredini
- Department of Neuroscience and Rehabilitation, University of Ferrara, Via Luigi Borsari 46, 44121 Ferrara, Italy; (N.L.); (F.N.); (A.C.); (I.C.); (S.S.)
- Unit of Rehabilitation Medicine, University Hospital of Ferrara, Via Aldo Moro 8, 44124 Ferrara, Italy; (A.B.); (N.B.)
- Correspondence: ; Tel.: +39-05322-36187
| | - Francesca Nardi
- Department of Neuroscience and Rehabilitation, University of Ferrara, Via Luigi Borsari 46, 44121 Ferrara, Italy; (N.L.); (F.N.); (A.C.); (I.C.); (S.S.)
| | - Andrea Baroni
- Unit of Rehabilitation Medicine, University Hospital of Ferrara, Via Aldo Moro 8, 44124 Ferrara, Italy; (A.B.); (N.B.)
| | - Giovanni Piva
- PhD Program in Environmental Sustainability and Wellbeing, University of Ferrara, Via Paradiso 12, 44121 Ferrara, Italy;
| | - Anna Crepaldi
- Department of Neuroscience and Rehabilitation, University of Ferrara, Via Luigi Borsari 46, 44121 Ferrara, Italy; (N.L.); (F.N.); (A.C.); (I.C.); (S.S.)
- PhD Program in Biomedicine, Instituto Maimónides de Investigación Biomédica de Córdoba, 14005 Córdova, Spain
| | - Nino Basaglia
- Unit of Rehabilitation Medicine, University Hospital of Ferrara, Via Aldo Moro 8, 44124 Ferrara, Italy; (A.B.); (N.B.)
| | - Ilaria Casetta
- Department of Neuroscience and Rehabilitation, University of Ferrara, Via Luigi Borsari 46, 44121 Ferrara, Italy; (N.L.); (F.N.); (A.C.); (I.C.); (S.S.)
- Unit of Clinical Neurology, University Hospital of Ferrara, Via Aldo Moro 8, 44124 Ferrara, Italy
| | - Sofia Straudi
- Department of Neuroscience and Rehabilitation, University of Ferrara, Via Luigi Borsari 46, 44121 Ferrara, Italy; (N.L.); (F.N.); (A.C.); (I.C.); (S.S.)
- Unit of Rehabilitation Medicine, University Hospital of Ferrara, Via Aldo Moro 8, 44124 Ferrara, Italy; (A.B.); (N.B.)
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van Kordelaar J, van de Ruit M, Solis-Escalante T, Aerden LAM, Meskers CGM, van Wegen EEH, Schouten AC, Kwakkel G, van der Helm FCT. The Cortical Response Evoked by Robotic Wrist Perturbations Reflects Level of Proprioceptive Impairment After Stroke. Front Hum Neurosci 2021; 15:695366. [PMID: 34858150 PMCID: PMC8631193 DOI: 10.3389/fnhum.2021.695366] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2021] [Accepted: 10/12/2021] [Indexed: 11/13/2022] Open
Abstract
Background: Proprioception is important for regaining motor function in the paretic upper extremity after stroke. However, clinical assessments of proprioception are subjective and require verbal responses from the patient to applied proprioceptive stimuli. Cortical responses evoked by robotic wrist perturbations and measured by electroencephalography (EEG) may be an objective method to support current clinical assessments of proprioception. Objective: To establish whether evoked cortical responses reflect proprioceptive deficits as assessed by clinical scales and whether they predict upper extremity motor function at 26 weeks after stroke. Methods: Thirty-one patients with stroke were included. In week 1, 3, 5, 12, and 26 after stroke, the upper extremity sections of the Erasmus modified Nottingham Sensory Assessment (EmNSA-UE) and the Fugl-Meyer Motor Assessment (FM-UE) and the EEG responses (64 channels) to robotic wrist perturbations were measured. The extent to which proprioceptive input was conveyed to the affected hemisphere was estimated by the signal-to-noise ratio (SNR) of the evoked response. The relationships between SNR and EmNSA-UE as well as SNR and time after stroke were investigated using linear regression. Receiver-operating-characteristic curves were used to compare the predictive values of SNR and EmNSA-UE for predicting whether patients regained some selective motor control (FM-UE > 22) or whether they could only move their paretic upper extremity within basic limb synergies (FM-UE ≤ 22) at 26 weeks after stroke. Results: Patients (N = 7) with impaired proprioception (EmNSA-UE proprioception score < 8) had significantly smaller SNR than patients with unimpaired proprioception (N = 24) [EmNSA-UE proprioception score = 8, t(29) = 2.36, p = 0.03]. No significant effect of time after stroke on SNR was observed. Furthermore, there was no significant difference in the predictive value between EmNSA-UE and SNR for predicting motor function at 26 weeks after stroke. Conclusion: The SNR of the evoked cortical response does not significantly change as a function of time after stroke and differs between patients with clinically assessed impaired and unimpaired proprioception, suggesting that SNR reflects persistent damage to proprioceptive pathways. A similar predictive value with respect to EmNSA-UE suggests that SNR may be used as an objective predictor next to clinical sensory assessments for predicting motor function at 26 weeks after stroke.
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Affiliation(s)
- Joost van Kordelaar
- Department of Biomechanical Engineering, Delft University of Technology, Delft, Netherlands
| | - Mark van de Ruit
- Department of Biomechanical Engineering, Delft University of Technology, Delft, Netherlands
| | - Teodoro Solis-Escalante
- Department of Biomechanical Engineering, Delft University of Technology, Delft, Netherlands.,Department of Rehabilitation, Donders Institute for Brain, Cognition and Behavior, Radboud University Medical Center, Nijmegen, Netherlands
| | - Leo A M Aerden
- Department of Neurology, Reinier de Graaf Hospital, Delft, Netherlands
| | - Carel G M Meskers
- Department of Rehabilitation Medicine, Amsterdam Neuroscience and Amsterdam Movement Sciences, Amsterdam University Medical Center, Amsterdam, Netherlands
| | - Erwin E H van Wegen
- Department of Rehabilitation Medicine, Amsterdam Neuroscience and Amsterdam Movement Sciences, Amsterdam University Medical Center, Amsterdam, Netherlands
| | - Alfred C Schouten
- Department of Biomechanical Engineering, Delft University of Technology, Delft, Netherlands.,Department of Biomedical Engineering, University of Twente, Enschede, Netherlands
| | - Gert Kwakkel
- Department of Rehabilitation Medicine, Amsterdam Neuroscience and Amsterdam Movement Sciences, Amsterdam University Medical Center, Amsterdam, Netherlands
| | - Frans C T van der Helm
- Department of Biomechanical Engineering, Delft University of Technology, Delft, Netherlands
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Bao SC, Chen C, Yuan K, Yang Y, Tong RKY. Disrupted cortico-peripheral interactions in motor disorders. Clin Neurophysiol 2021; 132:3136-3151. [PMID: 34749233 DOI: 10.1016/j.clinph.2021.09.015] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2021] [Revised: 08/08/2021] [Accepted: 09/19/2021] [Indexed: 11/15/2022]
Abstract
Motor disorders may arise from neurological damage or diseases at different levels of the hierarchical motor control system and side-loops. Altered cortico-peripheral interactions might be essential characteristics indicating motor dysfunctions. By integrating cortical and peripheral responses, top-down and bottom-up cortico-peripheral coupling measures could provide new insights into the motor control and recovery process. This review first discusses the neural bases of cortico-peripheral interactions, and corticomuscular coupling and corticokinematic coupling measures are addressed. Subsequently, methodological efforts are summarized to enhance the modeling reliability of neural coupling measures, both linear and nonlinear approaches are introduced. The latest progress, limitations, and future directions are discussed. Finally, we emphasize clinical applications of cortico-peripheral interactions in different motor disorders, including stroke, neurodegenerative diseases, tremor, and other motor-related disorders. The modified interaction patterns and potential changes following rehabilitation interventions are illustrated. Altered coupling strength, modified coupling directionality, and reorganized cortico-peripheral activation patterns are pivotal attributes after motor dysfunction. More robust coupling estimation methodologies and combination with other neurophysiological modalities might more efficiently shed light on motor control and recovery mechanisms. Future studies with large sample sizes might be necessary to determine the reliabilities of cortico-peripheral interaction measures in clinical practice.
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Affiliation(s)
- Shi-Chun Bao
- Department of Biomedical Engineering, The Chinese University of Hong Kong, Hong Kong
| | - Cheng Chen
- Department of Biomedical Engineering, The Chinese University of Hong Kong, Hong Kong
| | - Kai Yuan
- Department of Biomedical Engineering, The Chinese University of Hong Kong, Hong Kong
| | - Yuan Yang
- Stephenson School of Biomedical Engineering, University of Oklahoma, Tulsa, OK, USA; Laureate Institute for Brain Research, Tulsa, OK, USA; Department of Physical Therapy and Human Movement Sciences, Feinberg School of Medicine, Northwestern University, Chicago, IL, USA
| | - Raymond Kai-Yu Tong
- Department of Biomedical Engineering, The Chinese University of Hong Kong, Hong Kong.
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Snyder DB, Schmit BD, Hyngstrom AS, Beardsley SA. Electroencephalography resting-state networks in people with Stroke. Brain Behav 2021; 11:e02097. [PMID: 33759382 PMCID: PMC8119848 DOI: 10.1002/brb3.2097] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/24/2020] [Revised: 01/30/2021] [Accepted: 02/04/2021] [Indexed: 12/21/2022] Open
Abstract
INTRODUCTION The purpose of this study was to characterize resting-state cortical networks in chronic stroke survivors using electroencephalography (EEG). METHODS Electroencephalography data were collected from 14 chronic stroke and 11 neurologically intact participants while they were in a relaxed, resting state. EEG power was normalized to reduce bias and used as an indicator of network activity. Correlations of orthogonalized EEG activity were used as a measure of functional connectivity between cortical regions. RESULTS We found reduced cortical activity and connectivity in the alpha (p < .05; p = .05) and beta (p < .05; p = .03) bands after stroke while connectivity in the gamma (p = .031) band increased. Asymmetries, driven by a reduction in the lesioned hemisphere, were also noted in cortical activity (p = .001) after stroke. CONCLUSION These findings suggest that stroke lesions cause a network alteration to more local (higher frequency), asymmetric networks. Understanding changes in cortical networks after stroke could be combined with controllability models to identify (and target) alternate brain network states that reduce functional impairment.
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Affiliation(s)
- Dylan B Snyder
- Biomedical Engineering, Marquette University and Medical College of Wisconsin, Milwaukee, WI, USA
| | - Brian D Schmit
- Biomedical Engineering, Marquette University and Medical College of Wisconsin, Milwaukee, WI, USA
| | | | - Scott A Beardsley
- Biomedical Engineering, Marquette University and Medical College of Wisconsin, Milwaukee, WI, USA
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Zandvliet SB, Kwakkel G, Nijland RHM, van Wegen EEH, Meskers CGM. Is Recovery of Somatosensory Impairment Conditional for Upper-Limb Motor Recovery Early After Stroke? Neurorehabil Neural Repair 2020; 34:403-416. [PMID: 32391744 PMCID: PMC7222963 DOI: 10.1177/1545968320907075] [Citation(s) in RCA: 29] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/04/2022]
Abstract
Background. Spontaneous recovery early after stroke is most evident during a time-sensitive window of heightened neuroplasticity, known as spontaneous neurobiological recovery. It is unknown whether poststroke upper-limb motor and somatosensory impairment both reflect spontaneous neurobiological recovery or if somatosensory impairment and/or recovery influences motor recovery. Methods. Motor (Fugl-Meyer upper-extremity [FM-UE]) and somatosensory impairments (Erasmus modification of the Nottingham Sensory Assessment [EmNSA-UE]) were measured in 215 patients within 3 weeks and at 5, 12, and 26 weeks after a first-ever ischemic stroke. The longitudinal association between FM-UE and EmNSA-UE was examined in patients with motor and somatosensory impairments (FM-UE ≤ 60 and EmNSA-UE ≤ 37) at baseline. Results. A total of 94 patients were included in the longitudinal analysis. EmNSA-UE increased significantly up to 12 weeks poststroke. The longitudinal association between motor and somatosensory impairment disappeared when correcting for progress of time and was not significantly different for patients with severe baseline somatosensory impairment. Patients with a FM-UE score ≥18 at 26 weeks (n = 55) showed a significant positive association between motor and somatosensory impairments, irrespective of progress of time. Conclusions. Progress of time, as a reflection of spontaneous neurobiological recovery, is an important factor that drives recovery of upper-limb motor as well as somatosensory impairments in the first 12 weeks poststroke. Severe somatosensory impairment at baseline does not directly compromise motor recovery. The study rather suggests that spontaneous recovery of somatosensory impairment is a prerequisite for full motor recovery of the upper paretic limb.
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Affiliation(s)
- Sarah B. Zandvliet
- Department of Rehabilitation Medicine, Amsterdam Neuroscience and Amsterdam Movement Sciences, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, Netherlands
| | - Gert Kwakkel
- Department of Rehabilitation Medicine, Amsterdam Neuroscience and Amsterdam Movement Sciences, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, Netherlands
- Department of Physical Therapy and Human Movement Sciences, Northwestern University, Chicago, IL, USA
- Department of Neurorehabilitation, Amsterdam Rehabilitation Research Centre, Reade, Amsterdam, Netherlands
| | - Rinske H. M. Nijland
- Department of Neurorehabilitation, Amsterdam Rehabilitation Research Centre, Reade, Amsterdam, Netherlands
| | - Erwin E. H. van Wegen
- Department of Rehabilitation Medicine, Amsterdam Neuroscience and Amsterdam Movement Sciences, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, Netherlands
| | - Carel G. M. Meskers
- Department of Rehabilitation Medicine, Amsterdam Neuroscience and Amsterdam Movement Sciences, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, Netherlands
- Department of Physical Therapy and Human Movement Sciences, Northwestern University, Chicago, IL, USA
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