Highlights
- •Treatment of post-stroke spasticity increases interhemispheric parietal connectivity.
- •Ipsilesional intraparietal sulcus and contralesional superior parietal lobule linked.
- •Interhemispheric connectivity is negatively correlated with severity of spasticity.
Abstract
In post-stroke spasticity (PSS), effective treatment with botulinum neurotoxin (BoNT)
is associated with transient decrease in activation of the ipsilesional superior parietal
lobule (SPL) and intraparietal sulcus (IPS). We hypothesized that this would be reflected
in changes in resting-state functional connectivity (rsFC) of the SPL/IPS. Our aim
was therefore to assess rsFC of the ipsilesional SPL/IPS in chronic stroke patients
with hemiparesis both with and without PSS and to explore the relationship between
SPL/IPS rsFC and PSS severity. To this end, fourteen chronic stroke patients with
upper limb weakness and PSS (the PSS group) and 8 patients with comparable weakness
but no PSS (the control group) underwent clinical evaluation and 3 fMRI examinations,
at baseline (W0) and 4 and 11 weeks after BoNT (W4 and W11, respectively). Seed-based
rsFC of the atlas-based SPL and IPS was evaluated using a group×time interaction analysis
and a correlation analysis with PSS severity (modified Ashworth scale), integrity
of the ipsilesional somatosensory afferent pathway (evoked potential N20 latency),
and age. In the PSS group, transient improvement in PSS was associated with increase
in rsFC between the ipsilesional IPS and the contralesional SPL at W4. The interhemispheric
connectivity was negatively correlated with PSS severity at baseline and with PSS
improvement at W4. We propose adaptation of the internal forward model as the putative
underlying mechanism and discuss its possible association with increased limb use,
diminished spastic dystonia, or improved motor performance, as well as its potential
contribution to the clinical effects of BoNT.
Keywords
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Article info
Publication history
Published online: February 14, 2023
Accepted:
February 12,
2023
Received in revised form:
February 10,
2023
Received:
September 21,
2022
Identification
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