Inter-Limb Transfer in Acute Stroke

Over 3 consecutive days, healthy individuals, acute and chronic stroke patients will be evaluated and will train on the rehabilitation robot REAplan® (http://www.axinesis.com/) to assess proximal MSkL and on the manual dexterity tool Dextrain Manipulandum (https://www.dextrain.com/) to assess distal MSkL.

Healthy individuals, acute and chronic stroke patients will be randomised equally to 2 different groups. One group of participants will train over the 3 days on the serious game Circuit on the REAplan® and the game Targeting on the Dextrain Manipulandum. The other one will only be assessed on day 1 and day 3 on the serious games and will not have any training.

For proximal upper limb with the serious game Circuit, the participants will have to practice a complex circuit and move a cursor as quickly and accurately as possible by controlling the handle of the robot. A Reaching task and a Drawing task will be used to assess motor control.

For distal upper limb with the serious game Targeting, the participants will have to reach a series of targets with a cursor as quickly and accurately as possible by controlling their finger movements.

To explore the role of different brain structures in inter-limb transfer, Voxel-based Lesion Symptom Mapping (VLSM) based on high-resolution brain magnetic resonance imaging (MRI) scans, will be used to analyse the relationship between tissue damage and inter-limb transfer scores on a voxel-by-voxel basis.

Diffusion Tensor Imaging (DTI) will quantify the integrity of several white matter tracts, allowing through correlation analyses to unveil the white matter tracts crucial to achieve this transfer.

Moreover, several "classical" clinical scales and tests will be used to evaluate overall motor-sensory-cognitive functions.

ACUTE STROKE PATIENTS:

Inclusion criteria

• First acute ischemic or hemorrhagic stroke
• Between the 2nd and 21st day post-stroke
• Age: 40-90 years
• Ability to complete the 3 consecutive sessions

Exclusion criteria

• Stroke with multiple brain lesions
• Addiction (e.g., alcohol or drugs)
• Pregnancy
• Major cognitive impairment (e.g., depression, aphasia, dementia)
• Inability to perform or understand the required tasks
• Uncontrolled health conditions
• " classical " contre-indication to MRI (non-MR-compatible pacemaker, pregnancy, non-MR-compatible implanted devices, claustrophobia, etc ...)

HEALTHY INDIVIDUALS:

Inclusion criteria

• 40-90 years
• availability to complete three consecutive sessions.

Exclusion criteria

• "classical" contre-indication to MRI (non-MR-compatible pacemaker, pregnancy, non-MR-compatible implanted devices, claustrophobia, etc ...)
• medical history with a previous stroke/relevant neurological deficit or disease
• drug/alcohol abuse
• psychiatric condition/dementia
• having already used the robotic devices

CHRONIC STROKE PATIENTS:

Inclusion criteria

• single stroke confirmed by brain imaging
• time since stroke onset >6 months
• age between 40-90 years
• availability to complete three consecutive sessions.

Exclusion criteria

• Stroke with multiple brain lesions
• Addiction (e.g., alcohol or drugs)
• Pregnancy
• Major cognitive impairment (e.g., depression, aphasia, dementia)
• Inability to perform or understand the required tasks
• Uncontrolled health conditions
• having already used the robotic devices