Motor cortex activation during treatment may predict therapeutic gains in paretic hand function after stroke

Functional brain imaging after stroke offers insight into motor network adaptations. This exploratory study examined whether motor cortical activation captured during arm-focused therapy can predict paretic hand functional gains. Eight hemiparetic patients had serial functional MRI (fMRI) while perf...

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Bibliographic Details
Published in:Stroke (1970) 2006-06, Vol.37 (6), p.1552-1555
Main Authors: YUN DONG, DOBKIN, Bruce H, CEN, Steven Y, WU, Allan D, WINSTEIN, Carolee J
Format: Article
Language:English
Subjects:
Aged
Biological and medical sciences
Cardiovascular system
Hand - physiopathology
Headache. Facial pains. Syncopes. Epilepsia. Intracranial hypertension. Brain oedema. Cerebral palsy
Humans
Magnetic Resonance Imaging
Medical sciences
Middle Aged
Motor Cortex - physiopathology
Nervous system (semeiology, syndromes)
Neurology
Paresis - diagnosis
Paresis - etiology
Paresis - physiopathology
Paresis - therapy
Pharmacology. Drug treatments
Physical Therapy Modalities
Predictive Value of Tests
Stroke - complications
Vascular diseases and vascular malformations of the nervous system
Vasodilator agents. Cerebral vasodilators
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Summary:Functional brain imaging after stroke offers insight into motor network adaptations. This exploratory study examined whether motor cortical activation captured during arm-focused therapy can predict paretic hand functional gains. Eight hemiparetic patients had serial functional MRI (fMRI) while performing a pinch task before, midway, and after 2 weeks of constraint-induced therapy. The Wolf Motor Function Test (WMFT) was performed before and after intervention. There was a linear reduction in ipsilateral (contralesional) primary motor (M1) activation (voxel counts) across time. The midpoint M1 Laterality Index anticipated post-therapeutic change in time to perform the WMFT. The change in ipsilateral M1 voxel count (pre- to mid-) correlated with the change in mean WMFT time (pre- to post-). The relationship between brain activation during treatment and functional gains suggests a use for serial fMRI in predicting the success and optimal duration for a focused therapeutic intervention.
ISSN:0039-2499
1524-4628
DOI:10.1161/01.str.0000221281.69373.4e