Affiliations: [a] Department of Physical Medicine & Rehabilitation, School of Medicine Yeungnam University, Taegu, Republic of Korea | [b] Department of Physical Therapy Program, Yonsei University, Wonju, Republic of Korea
Correspondence:
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Address for correspondence: Sung (Joshua) H. You, PT, PhD, Department of Physical Therapy, Graduate School of Rehabilitation Therapy, Yonsei University, Director of Yonsei University Virtual Reality (YUVR) Education & Research Center, 234 Heoungup-Myon, MaeJi-Ri, Wonju City, Kangwon-do, Republic of S. Korea 220-710. Tel.: (011 82 for International) 033 760 2476; Fax: +82 33 760 2496; E-mail: neurorehab@yonsei.ac.kr/neurorehab1@yahoo.com
Abstract: Purpose:This study highlights the effects of a comprehensive neurorehabilitation (CN) on neuroplasticity and motor recovery in a 25 years old adult with right hippocampal sclerosis and the temporal lobectomy and amygdalotomy. Methods:The patient received 8-month course of comprehensive neurorehabilitation, comprised of five times/week. Motor behavioral and 1.5 T functional magnetic resonance imaging (fMRI) tests were implemented to determine the restoration of motor function and neuroplasitic changes, respectively. In fMRI measure, a laterality index (LI) was used to determine any shift in the symmetry of cortical activation between the hemispheres. Additionally, motor behavioral changes were measured to probe long-term retention of learned motor skills at the 6-month post-treatment follow-up test. Results:Motor behavioral tests showed that comprehensive neurorehabilitation enhanced functional reaching, grasping, and hand manipulation skills, which were well retained even at the 6-month post-treatment. Baseline fMRI showed asymmetry of the contralesional sensori-motor cortex (SMC) activation (Laterality index score: 0.54), but was restored to normal symmetry (Lateral index: 1.0) during affected hand movement after comprehensive neurorehabilitation. Conclusions:Our novel findings suggest that comprehensive neurorehabilitation may facilitate restitution of normal symmetry of cortical activation, thereby enhancing motor function. This case provides the first neuroimaging evidence about a long-term comprehensive neurorehabilitation -induced neuroplasticity of the individual with a complex brain injury in the literature.
