Neural Pathways of Applied Reflexology using Real-Time Task-Based and Resting-State fMRI in Healthy Controls and Patients with Stroke

Motivation: To characterize the biological substrates and mechanisms of reflexology. Goal(s): (1) To characterize the somatotopic relationship between cortical activity and sensory stimulation of reflex areas. (2) To assess possible therapeutic effects of reflexology. Approach: Real-time task-based and resting-state fMRI in 4 controls and 4 adults with stroke using multi-band multi-echo EPI. Results: Deactivation of a bilateral network in superior-temporal gyrus, postcentral gyrus and insular cortex (depending on reflex area) in healthy controls and unilateral deactivation, which differed between left and right foot, in patients with stroke. Sensorimotor function in the hemiplegic hand improved (3 patients) and two-point discrimination increased (2 patients) after reflexology. Impact: This preliminary real-time fMRI study demonstrates the potential to change the reflexologist’s technique application to focus on particular reflex areas for optimizing treatment results and to establish a neurobiological basis for predicting treatment outcomes in patients with neurological disorders.