All ETDs from UAB

Advisory Committee Chair

Edward Taub

Advisory Committee Members

Jane Allendorfer

Victor W Mark

Gitendra Uswatte

Jarred Younger

Document Type

Dissertation

Date of Award

2019

Degree Name by School

Doctor of Philosophy (PhD) College of Arts and Sciences

Abstract

Constraint-Induced Movement therapy (CI therapy) is an efficacious physical rehabilitation intervention for lateralized upper-extremity motor deficits resulting from neurological injury or disease, which has been shown to result in use-dependent structural and functional neuroplasticity. While use-dependent neuroplasticity has been shown to result in structural changes in brain tissue density, thickness, and volume, the exact cellular mechanisms underpinning this neuroplasticity in humans have yet to be determined. The present study involved a novel use of synthetic data, with the overall aim of elucidating the nature of structural use-dependent neuroplasticity produced by CI therapy. Longitudinal voxel-based morphometry (VBM) and tensor-based morphometry (TBM) are two alternative pipelines for analyzing structural use-dependent neuroplasticity in magnetic resonance images (MRIs). To determine whether these methods are differentially sensitive to changes in density, thickness, and volume within brains from individuals with multiple sclerosis (MS), individuals with chronic stroke, and healthy individuals, we artificially changed the MRIs to give the appearance that an isolated change had occurred in just one of the above characteristics. VBM and TBM showed different patterns of results based on the type of artificial change, albeit with some variability between samples. We then applied VBM and TBM to real longitudinal data from individuals with MS or chronic stroke who had completed CI therapy, then compared the patterns of results to the patterns seen in the earlier analyses of artificial data. In the MS sample, CI therapy resulted in a combination of increased density and increased volume and/or thickness within the brain region controlling the rehabilitated upper-extremity. In the stroke sample, CI therapy primarily resulted in increased volume in this region. These patterns of structural changes, alongside complementary data from other MRI modalities (e.g., functional MRI, magnetic resonance spectroscopy), will help elucidate the cellular mechanisms underpinning use-dependent neuroplasticity in humans.

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