Effects of virtual reality therapy on upper limb function after stroke and the role of neuroimaging as a predictor of a better response

ABSTRACT Background: Virtual reality therapy (VRT) is an interactive intervention that induces neuroplasticity. The aim was to evaluate the effects of VRT associated with conventional rehabilitation for an upper limb after stroke, and the neuroimaging predictors of a better response to VRT. Methods: Patients with stroke were selected, and clinical neurological, upper limb function, and quality of life were evaluated. Statistical analysis was performed using a linear model comparing pre- and post-VRT. Lesions were segmented in the post-stroke computed tomography. A voxel-based lesion-symptom mapping approach was used to investigate the relationship between the lesion and upper limb function. Results: Eighteen patients were studied (55.5 ± 13.9 years of age). Quality of life, functional independence, and dexterity of the upper limb showed improvement after VRT (p

摘要 背景：虚拟现实疗法（Virtual Reality Therapy, VRT）是一种可诱导神经可塑性的交互式干预手段。本研究旨在评估VRT联合常规康复治疗对脑卒中后上肢功能的疗效，以及筛选可预测VRT更佳治疗响应的神经影像学预测因子。方法：本研究纳入脑卒中患者，对其临床神经功能、上肢功能及生活质量进行评估。采用线性模型对比VRT治疗前后的相关指标以开展统计学分析。对脑卒中后计算机断层扫描（computed tomography, CT）影像中的病灶进行分割，并采用基于体素的病灶-症状映射（voxel-based lesion-symptom mapping, VLSM）方法探究病灶与上肢功能之间的关联。结果：本研究共纳入18例患者，年龄为55.5 ± 13.9岁。VRT治疗后，患者的生活质量、功能独立性及上肢灵活性均得到改善（p