The role of ventral tegmental area in chronic stroke rehabilitation: an exploratory study

Astrakas, Loukas G., Elbach, Sabrina, Giannopulu, Irini, Li, Shasha, Benjafield, Howard and Tzika, A. Aria (2023) The role of ventral tegmental area in chronic stroke rehabilitation: an exploratory study. Frontiers in neurology, 14. pp. 1-9. ISSN 1664-2295

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Official URL: https://doi.org/10.3389/fneur.2023.1270783

Abstract / Description

Introduction:
The acknowledged role of external rewards in chronic stroke rehabilitation, offering positive reinforcement and motivation, has significantly contributed to patient engagement and perseverance. However, the exploration of self-reward’s importance in this context remains limited. This study aims to investigate the functional connectivity of the ventral tegmental area (VTA), a key node in the brain’s reward circuitry, during motor task-based rehabilitation and its correlation with the recovery process.

Methods:
Twelve right-handed healthy volunteers (4 men, 8 women, aged 57.4 ± 11.3 years) and twelve chronic stroke patients (5 men, 7 women, aged 48.1 ± 11.1 years) with clinically significant right-sided motor impairment (mean FM-UE score of 27.6 ± 8.7) participated. The analysis employed the CONN toolbox to assess the association between motor tasks and VTA connectivity using psychophysiological interaction (PPI).

Results:
PPI analysis revealed motor-dependent changes in VTA connectivity, particularly with regions within the motor circuitry, cerebellum, and prefrontal cortex. Notably, stronger connectivity between the ipsilesional VTA and cerebellum was observed in healthy controls compared to chronic stroke patients, highlighting the importance of VTA-cerebellum interactions in motor function. Stroke patients’ motor performance was associated with VTA modulation in areas related to both motor tasks and reward processing, emphasizing the role of self-reward processes in rehabilitation. Changes in VTA influence on motor circuitry were linked to improvements in motor performance resulting from rehabilitation.

Discussion:
Our findings underscore the potential of neuroimaging techniques in quantifying and predicting rehabilitation outcomes by examining self-reward processes. The observed associations between VTA connectivity and motor performance in both healthy and stroke-affected individuals emphasize the role of psychological factors, particularly self-reward, in the rehabilitation process. This study contributes valuable insights into the intricate interplay between reward circuits and motor function, highlighting the importance of addressing psychological dimensions in neurorehabilitation strategies.

Item Type: Article
Additional Information: Abstract copyright: Copyright © 2023 Astrakas, Elbach, Giannopulu, Li, Benjafield and Tzika.
Uncontrolled Keywords: psychophysiological interaction; chronic stroke; rehabilitation; reward; ventral tegmental area; Fugl-Meyer upper extremity scale
Subjects: 600 Technology > 610 Medicine & health
Department: School of Social Sciences and Professions
SWORD Depositor: Pub Router
Depositing User: Pub Router
Date Deposited: 01 Feb 2024 16:02
Last Modified: 01 Feb 2024 16:02
URI: https://repository.londonmet.ac.uk/id/eprint/9035

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