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Title: Evolution of brain activation with good and poor motor recovery after stroke.
Austin Authors: Carey, Leeanne M ;Abbott, David F ;Egan, Gary F;O'Keefe, Graeme J;Jackson, Graeme D ;Bernhardt, Julie;Donnan, Geoffrey A 
Affiliation: National Stroke Research Institute, Austin Health, Heidelberg West, Victoria, Australia, LaTrobe University, Bundoora, Victoria, Australia
Issue Date: 1-Mar-2006
Publication information: Neurorehabilitation and Neural Repair; 20(1): 24-41
Abstract: To characterize the evolution of brain activation in stroke patients with variable motor recovery and quantify changes relative to healthy controls.Serial PET activation studies, using a simple finger-tapping task, and quantitative measures of motor performance were obtained in 9 patients (2-7 weeks poststroke and 6 months later) and compared with serial healthy volunteer data.Patients with moderate impairment and good recovery (n = 5) activated the primary sensorimotor cortex (SM1) contralateral to the paretic hand moved, bilateral supplementary motor area (SMA), contralateral cingulate gyrus, and ipsilateral lateral premotor cortex. Activation in the bilateral SMA was greater at the initial study but reduced over time compared to healthy controls and poor recoverers. Patients with severe impairment and poor recovery (n =4) showed limited activation of contralateral SM1 and SMA at both studies and no significant change over time. A posterior shift in SM1 activation was evident in good and poor recoverers.Activation of typical motor regions and recruitment of additional sites occur subacutely poststroke, with evolution to normal patterns in moderately impaired patients who recover well. In comparison, severely impaired, poor-recovery patients show persistent, reduced activation. Dynamic changes in SMA, differentially observed in good recoverers over 6 months, highlight its importance in recovery.
Gov't Doc #: 16467276
DOI: 10.1177/1545968305283053
Journal: Neurorehabilitation and neural repair
Type: Journal Article
Subjects: Aged
Aged, 80 and over
Brain Mapping
Case-Control Studies
Cerebral Cortex.physiopathology.radionuclide imaging
Cerebrovascular Circulation.physiology
Infarction, Middle Cerebral Artery.physiopathology.radionuclide imaging
Middle Aged
Motor Activity.physiology
Recovery of Function.physiology
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