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Neurological Sciences

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01-02-2021 | Stroke | Review Article

The modulatory effects of bilateral arm training (BAT) on the brain in stroke patients: a systematic review

Authors: Jingyi Wu, Hao Cheng, Jiaqi Zhang, Zhongfei Bai, Sufang Cai

Published in: Neurological Sciences | Issue 2/2021

Abstract

Objective

To systematically review the modulatory effects of bilateral arm training (BAT) on the brain of stroke patients in contrast to unilateral arm training (UAT) or regular motor training.

Methods

We conducted a literature search using PubMed, EMBASE, MEDLINE, and Science Citation Index Expanded databases from the inception to March 2019 for identifying any relevant studies. Two authors independently screened the literature, extracted data, and qualitatively described the included studies.

Results

Eleven studies with a total of 225 stroke patients were included in this review. 156 out of those participants received neuroimaging or neurophysiological examinations. Six studies reported enhanced activation of the ipsilesional primary motor area (M1) induced by BAT, as measured by MEP and fMRI. Beyond the M1, three studies showed that supplementary motor area (SMA) was activated, and three studies found the primary sensory cortex area (S1) was activated by BAT in stroke patients, as measured by fMRI. One article showed that the inter-/intra-hemispheric functional connections of the sensorimotor network were more highly strengthened after BAT than regular motor training, in particular the functional connectivity between the SMA and the M1 in the bi-hemispheres. Three studies reported that BAT increased the inhibitory flow from the ipsilesional hemisphere to the contralesional hemisphere, as measured by interhemispheric transcallosal inhibition (IHI). However, the superiority of BAT in inducing a symmetric IHI than UAT was controversial.

Conclusion

BAT is potentially more effective than UAT in improving upper limb recovery after stroke by activating the ipsilesional primary motor area (M1), supplementary motor area (SMA), and primary sensory cortex (S1) and enhancing the intra-hemispheric and interhemispheric connectivity within the sensorimotor network and the cortical motor system.

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Title: The modulatory effects of bilateral arm training (BAT) on the brain in stroke patients: a systematic review
Authors: Jingyi Wu
Hao Cheng
Jiaqi Zhang
Zhongfei Bai
Sufang Cai
Publication date: 01-02-2021
Publisher: Springer International Publishing
Keywords: Stroke
Motor Evoked Potential
Motor Evoked Potential
Published in: Neurological Sciences / Issue 2/2021
Print ISSN: 1590-1874
Electronic ISSN: 1590-3478
DOI: https://doi.org/10.1007/s10072-020-04854-z

Keynote webinar | Spotlight on medication adherence

Springer Medicine

The modulatory effects of bilateral arm training (BAT) on the brain in stroke patients: a systematic review

Abstract

Objective

Methods

Results

Conclusion

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Objective

Methods

Results

Conclusion

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