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

By N. Ward, M. M. Brown, Alan J. Thompson, Richard S. J. Frackowiak. Brain : a journal of neurology, 2003

667 citations recorded by the source corpus.

Summary 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.

Subfields: Neurology, Radiology, Nuclear Medicine and Imaging, Rehabilitation

View Paper: https://www.semanticscholar.org/paper/19907c709e4e5b27b8cbde57846d096112098bba

How researchers see this paper

The researchers whose trusted networks rank it highest, strongest advocate first. Every researcher gets a different order.

In Neurology

In Radiology, Nuclear Medicine and Imaging

In Rehabilitation

Citations in the corpus

Transcallosal inhibition in chronic subcortical stroke (2005, background): “, 2003) and decreases over time with rehabilitation (Ward et al., 2003).”
Activation likelihood estimation meta-analysis of motor-related neural activity after stroke (2012, background): “Some studies with well-recovered patients also reported more focal activity in ipsilesional motor areas (Calautti et al., 2001; Ward et al., 2003a,b), underlining that good motor performance depends on efficient M1 activation.”
Functional potential in chronic stroke patients depends on corticospinal tract integrity. (2006, background): “…potential in chronic stroke patients depends on corticospinal tract integrity Cathy M. Stinear,1 P. Alan Barber,2 Peter R. Smale,1,3 James P. Coxon,1 Melanie K. Fleming1 and Winston D. Byblow1 1Human Motor Control Laboratory, University of Auckland, 2Neurology Department and 3Radiology Department,”
Ankle dorsiflexion as an fMRI paradigm to assay motor control for walking during rehabilitation (2004, background): “…behavioral gains to changes within cerebral sensorimotor regions of interest (ROIs) over the course of a specific therapy or general approach to rehabilitation (Carey et al., 2002; Johansen-Berg et al., 2002; Liepert et al., 2000; Nelles et al., 2001; Ward et al., 2003b; Wittenberg et al., 2003).”
Repairing the human brain after stroke: I. Mechanisms of spontaneous recovery (2008, background): “This decline is greater among patients with better behavioral outcome, because the degree of persistently increased activity in both instances is generally greatest in those with the poorest behavioral outcome.(77,153,156) However, note that persistent, increased reorganization is not always helpful”
Neural correlates of motor recovery after stroke: a longitudinal fMRI study (2003, methodology): “In addition to the above questions, we were interested to see whether a correlation existed between task-related activation patterns and the degree of impairment in the post-acute phase, similar to the correlation we previously described in the chronic phase (Ward et al., 2003).”
Harnessing neuroplasticity for clinical applications (2011, neutral): “For example, (B) shows data from Ward et al. (2003).”