Changes in Cerebellar Activation After Onabotulinumtoxin A Injections for Spasticity After Chronic Stroke: A Pilot Functional Magnetic Resonance Imaging Study

Publication date: November 2015
Source:Archives of Physical Medicine and Rehabilitation, Volume 96, Issue 11
Author(s): Chia-Lin Chang, Douglas J. Weber, Michael C. Munin
ObjectiveTo investigate the effect of reducing spasticity via onabotulinumtoxin A (Obtx-A) injection on cerebellar activation after chronic stroke during unilateral gripping.DesignPre-post, case series.SettingOutpatient spasticity clinic.ParticipantsIndividuals with chronic spasticity (N=4).InterventionsUpper-limb Obtx-A injection.Main Outcome MeasuresFunctional magnetic resonance imaging (fMRI) was used to measure changes in cerebellar activation before and after upper-limb Obtx-A injection. During fMRI testing, participants performed the same motor task before and after injection, which was 15% and 30% of maximum voluntary isometric gripping measured before Obtx-A injection.ResultsAfter Obtx-A injection, cerebellar activation increased bilaterally during gripping with the paretic hand and during rest. During both pre- and postinjection scans, the paretic hand showed larger cerebellar activation during gripping compared with the nonparetic hand. Cerebellar activation during gripping with the nonparetic hand did not change significantly after Obtx-A injection.ConclusionsReducing spasticity via Obtx-A injection may increase cerebellar activation both during gripping tasks with the paretic hand and during rest. To our knowledge, this is the first study that examines changes in cerebellar activation after spasticity treatment with Obtx-A.



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