Effects of mirror therapy on motor aphasia after acute cerebral infarction: A randomized controlled trial

Article type: Research Article

Authors: Chen, Qingmei^{a; b; 1} | Shen, Wenjun^{c; 1} | Sun, Haiwei^{e; 1} | Shen, Dan^a | Cai, Xiuying^a | Ke, Jun^{d; 2} | Zhang, Lichi^{c; 2; *} | Fang, Qi^{a; 2; *}

Affiliations: [a] Department of Neurology, The First Affiliated Hospital of Soochow University, Suzhou, Jiangsu Province, China | [b] Department of Physical Medicine & Rehabilitation, The First Affiliated Hospital of Soochow University, Suzhou, Jiangsu Province, China | [c] School of Biomedical Engineering, Shanghai Jiao Tong University, Shanghai, China | [d] Department of Radiology, The First Affiliated Hospital of Soochow University, Suzhou, Jiangsu Province, China | [e] Department of Emergency Medicine, The Second Affiliated Hospital of Soochow University, Suzhou, Jiangsu Province, China

Correspondence: [*] Address for correspondence: Qi Fang, MD, Ph.D. Department of Neurology, The First Affiliated Hospital of Soochow University, Pinghai Road 899, Suzhou, Jiangsu, 215000, China. Tel.: +86 13606213892; E-mail: fangqi@suda.edu.cn. and Lichi Zhang, Ph.D. School of Biomedical Engineering, Shanghai Jiao Tong University, No 1954, Hua Shan Road, Shanghai, 200030, China. Tel.: +86 18721437546; E-mail: lichizhang@sjtu.edu.cn.

Note: [1] Qingmei Chen, Wenjun Shen and Haiwei Sun are co-first authors

Note: [2] Jun Ke, Lichi Zhang and Qi Fang are co-corresponding authors.

Abstract: BACKGROUND:Mirror therapy (MT) has proven to be beneficial for treating patients suffering from motor aphasia after stroke. However, the impacts of MT on neuroplasticity remain unexplored. OBJECTIVE:In this paper we conducted a randomized controlled trial to evaluate the treatment using the MT on motor aphasia following acute cerebral infarction. METHODS:We randomly assigned 30 patients into test and control groups, with test group patients treated with MT, whereas control group patients were treated with sham MT. At 24 hours prior to and after the intervention, we obtained functional magnetic resonance imaging (fMRI) data from study subjects. At baseline, after treatment and 12-week follow-up, we additionally evaluated patients with the Modified Rankin Scale (mRS), the National Institutes of Health Stroke Scale (NIHSS), and the aphasia quotient (AQ) in the western aphasia test. RESULTS:After 2 weeks of treatment, the test group demonstrated significant improvements in AQ values, naming, repetition, spontaneous speech, and mRS scores compared to the control group (P < 0.05). Furthermore, in the follow-up time point (12 weeks), we found that the test group exhibited significantly better NIHSS scores and AQ evaluation indicators than the control group (P < 0.05). Specifically, the fMRI study shows that functional connectivity significantly improved in test group patients mainly among frontal, temporal, and parietal lobes of the left hemisphere with each other than controls group. Meanwhile, we found significantly enhanced functional connectivity with the hippocampus (P < 0.01). CONCLUSIONS:Our results indicate that the MT can expedite the recovery of language function during the early phases of stroke recovery. These findings may elucidate the underlying mechanism of MT and the application of this therapy as an adjunct rehabilitation technique in language recovery.

Keywords: Mirror therapy, acute cerebral infarction, motor aphasia, rehabilitation, neural mechanism, functional magnetic resonance imaging

DOI: 10.3233/NRE-210125

Journal: NeuroRehabilitation, vol. 49, no. 1, pp. 103-117, 2021