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Title: Motor impairment and recovery in the upper limb after stroke: behavioral and neuroanatomical correlates.
Authors: Carey, Leeanne M;Abbott, David F;Egan, Gary F;Bernhardt, Julie;Donnan, Geoffrey A
Affiliation: National Stroke Research Institute, Austin Health, Level 2, Neurosciences Building, Banksia St, Heidelberg West, Victoria, Australia 3081.
Issue Date: 27-Jan-2005
Citation: Stroke; A Journal of Cerebral Circulation 2005; 36(3): 625-9
Abstract: Motor recovery after stroke is associated with cerebral reorganization. However, few studies have investigated the relationship directly, and findings are equivocal. We therefore aimed to characterize the relationship between motor impairment, motor recovery, and task-related changes in regional cerebral blood flow (DeltarCBF) longitudinally.We obtained a profile of motor impairment and recovery in the upper limb and conducted positron emission tomography motor activation studies using a simple finger-tapping task in 9 stroke patients 2 to 7 weeks after stroke and 6 months later. For correlation analysis, mean images of task-related DeltarCBF for each individual were linearly regressed with motor impairment scores. Motor recovery was correlated with longitudinal DeltarCBF images.Patients (7 males; 72.0+/-9.8 years) demonstrated a wide range of impairment severity and variable recovery. Upper-limb motor function was linearly correlated with task-related DeltarCBF. Importantly, sites of correlated DeltarCBF differed over time. Subacutely correlated DeltarCBF was observed in supplementary motor area (SMA), bilateral cingulate, and contralesional insula with a small area in ipsilesional primary sensorimotor cortex (SM1). Conversely, at the 6-month study, correlated DeltarCBF was primarily in ipsilesional SM1, extending to the cingulate gyrus. Better motor recovery was correlated with reduction in contralesional activity and increase in ipsilesional SM1.Upper-limb motor function and recovery are correlated with DeltarCBF in SMA, cingulate, insula, and SM1, highlighting the role of these areas in the recovery process. The dynamic nature of the relationship suggests ongoing adaptation within motor networks.
Internal ID Number: 15677574
DOI: 10.1161/01.STR.0000155720.47711.83
Type: Journal Article
Subjects: Aged
Cerebral Cortex.blood supply.pathology.physiopathology
Cerebral Infarction.pathology.physiopathology
Positron-Emission Tomography.methods
Psychomotor Performance.physiology
Recovery of Function.physiology
Regional Blood Flow.physiology
Upper Extremity.physiopathology
Appears in Collections:Journal articles

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