Recruitment of the central nervous system in different hand tasks in patients with hand dysfunction after stroke based on functional near-infrared spectroscopy: an exploratory study.

Abstract

This study aimed to examine the central nervous system activation in stroke patients with hand dysfunction during various hand tasks, reflecting central nervous system recruitment. A single-centre cross-sectional observational study. This research selected stroke patients with hand dysfunction hospitalized in the authors' hospital from October 2022 to November 2023. Participants were aged 25-75 years, with a post-stroke duration ranging from 2 to 24 weeks. A 35-channel functional near-infrared spectroscopy system was used to record cortical activity during the resting state, affected-hand grasping tasks, and hand-crank cycling tasks. The study compared the average brain activation extent and functional connectivity between grasping and handbike tasks, focusing on the primary sensorimotor cortex, dorsolateral prefrontal cortex, primary motor cortex, and primary somatosensory cortex as regions of interest. Comparative analysis of brain region activation revealed significant increases in activation across all regions of interest compared with the resting state (p < 0.001). When comparing grasping with handbike tasks, significant increases in activation were observed in all regions of interest except the right primary somatosensory cortex (p < 0.05). Additionally, the right dorsolateral prefrontal cortex exhibited stronger functional connectivity with bilateral primary motor cortex, primary sensorimotor cortex, and left primary somatosensory cortex during the grasping task compared with the handbike task (p < 0.05). This study shows that grasping tasks recruit cognitive, sensory, and motor cortex activities in stroke patients with hand dysfunction relatively higher than handbike tasks.