Neural correlates of outcome after stroke: a cross-sectional fMRI study.

Details

Serval ID
serval:BIB_841133893A24
Type
Article: article from journal or magazin.
Collection
Publications
Title
Neural correlates of outcome after stroke: a cross-sectional fMRI study.
Journal
Brain
Author(s)
Ward N.S., Brown M.M., Thompson A.J., Frackowiak R.S.
ISSN
0006-8950 (Print)
ISSN-L
0006-8950
Publication state
Published
Issued date
2003
Volume
126
Number
Pt 6
Pages
1430-1448
Language
english
Notes
Publication types: Journal Article ; Research Support, Non-U.S. Gov'tPublication Status: ppublish
Abstract
Recovery of motor function after stroke may occur over weeks or months and is often attributed to neuronal reorganization. Functional imaging studies investigating patients who have made a good recovery after stroke have suggested that recruitment of other motor-related networks underlies this recovery. However, patients with less complete recovery have rarely been studied, or else the degree of recovery has not been taken into account. We set out to investigate the relationship between the degree of recovery after stroke and the pattern of recruitment of brain regions during a motor task as measured using functional MRI. We recruited 20 patients who were at least 3 months after their first ever stroke, and 26 right-handed age-matched control subjects. None of our patients had infarcts involving the hand region of the primary motor cortex. All subjects were scanned whilst performing an isometric, dynamic visually paced handgrip task. The degree of functional recovery of each patient was assessed using a battery of outcome measures. Single-patient versus control group analysis revealed that patients with poor recovery were more likely to recruit a number of motor-related brain regions over and above those seen in the control group during the motor task, whereas patients with more complete recovery were more likely to have 'normal' task-related brain activation. Across the whole patient group and across stroke subtypes, we were able to demonstrate a negative correlation between outcome and the degree of task-related activation in regions such as the supplementary motor area, cingulate motor areas, premotor cortex, posterior parietal cortex, and cerebellum. This negative correlation was also seen in parts of both contralateral and ipsilateral primary motor cortex. These results further our understanding of the recovery process by demonstrating for the first time a clear relationship between task-related activation of the motor system and outcome after stroke.
Keywords
Adult, Aged, Aged, 80 and over, Female, Hand Strength, Health Status Indicators, Humans, Image Processing, Computer-Assisted, Magnetic Resonance Imaging/methods, Male, Middle Aged, Motor Cortex/pathology, Motor Cortex/physiopathology, Motor Skills, Neuronal Plasticity, Prognosis, Recovery of Function, Stroke/pathology, Stroke/physiopathology
Pubmed
Web of science
Open Access
Yes
Create date
11/09/2011 19:43
Last modification date
08/05/2019 21:18
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