Interpreting Intervention Induced Neuroplasticity with fMRI: The Case for Multimodal Imaging Strategies

Table 1

Example of multimodal studies of brain injury and neuroplasticity.

Reference	Disorder	Additional measures(s)	Significance
Werring et al. [3]	TBI	dMRI	Earliest known combined fMRI + dMRI study for a recovering patient. Combined imaging revealed which corticospinal tracts were partially damaged and whether they were still in use.
Palmer et al. [4]	Healthy subjects	dMRI tractography	fMRI-guided tractography elucidated minute longitudinal structural changes; changes were not detected by fMRI alone.
Cherubini et al. [5]	TBI	dMRI tractography	In patients, fMRI-guided tractography identified additional corticospinal connections and more normal connectivity patterns than atlas-based seeding.
Staudt et al. [6]	CP	dMRI, TMS	TMS, dMRI, and fMRI of motor areas showed good agreement, except in the only successfully scanned subject with bilateral fMRI activation. For this subject, TMS and dMRI ruled out an ipsilateral CST connection.
Rijntjes et al. [7]	Stroke	TMS	Integrity of the pyramidal tract was required for patients to show lasting responses to CIMT. Long term outcomes, fMRI patterns, and correlations between these factors were dependent on such integrity.
Wilke et al. [8]	CP	TMS, MEG	Multimodal imaging demonstrated that sensory organisation was preserved despite motor reorganisation.
Schaechter et al. [9]	Stroke	Cortical thickness	fMRI activations correlated with cortical thickness specifically in putative area 3b of the lesioned hemisphere.
Xiong et al. [10]	Healthy subjects	PET	The fact that fMRI “returns to baseline” in long term motor training may be due to an increased baseline rCBF, rather than the assumed decrease in activation during task performance.

TBI: traumatic brain injury; dMRI: diffusion MRI; CIMT: constraint-induced movement therapy; CP: cerebral palsy; TMS: transcranial magnetic stimulation; MEG: magnetoencephalography; PET: positron emission tomography.