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Master Thesis

Étude des bases neurales de l'asymétrie d'appui

Abstract : Objective. Weight Bearing Asymmetry (WBA) occurs frequently after a stroke and can be severe. It is a complex postural behaviour, linked to muscle weakness, Unilateral spatial neglect (USN), spatial representation and verticality. The neural determinants of WBA have never been studied. This study is a first attempt to determine the neural bases of WBA. Methods. This is a cohort study of 72 inpatients (43 patients with right-sided and 29 patients with leftsided lesions) with both MRI and posturographic assessment (obtained with a two-force platform) in the subacute stage after a first hemispheric stroke. Anatomo-correlation was achieved using the Voxel Lesion Symptom Mapping (VLSM) method with the SVLRSMGui software (Zhang et al., 2014) to analyse grey matter, and using tractotron on BCBToolkit to analyse white matter (Foulon et al., 2018). Results. VLSM analysis reveals a strong association between WBA and cortical structures (posterior parietal cortex, posterior insula) and subcortical structures (postero-lateral thamalus and putamen). Regarding white matter tracts, the cortico-spinal tract (CST) and superior longitudinal fasciculus (SLF) seem to be involved, but the correlation is not statistically significant. Conclusion. This is the first study to investigate and identify the neural bases of weight-bearing control in standing position, using a series of 72 individuals tested at the subacute stage after a first hemispheric stroke. Concerning grey matter, the parietal cortex, posterior insula, putamen, and posterior-lateral thalamus are related to weight bearing asymmetry. Together these contribute to construct spatial representations in order to stand upright. Concerning white matter, the involvement of the SLF and the CST should be specifically analysed in further studies.
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Master Thesis
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https://dumas.ccsd.cnrs.fr/dumas-03332450
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Submitted on : Thursday, September 30, 2021 - 9:59:36 AM
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  • HAL Id : dumas-03332450, version 1

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Adélie Christiaens. Étude des bases neurales de l'asymétrie d'appui. Médecine humaine et pathologie. 2020. ⟨dumas-03332450⟩

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