Neural correlates of motor recovery after stroke: a longitudinal fMRI study

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

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Summary Recovery of motor function after stroke may occur over weeks or months and is often attributed to cerebral reorganization. We have investigated the longitudinal relationship between recovery after stroke and task-related brain activation during a motor task as measured using functional MRI (fMRI). Eight first-ever stroke patients presenting with hemiparesis resulting from cerebral infarction sparing the primary motor cortex, and four control subjects were recruited. Subjects were scanned on a number of occasions whilst performing an isometric dynamic visually paced hand grip task. Recovery in the patient group was assessed using a battery of outcome measures at each time point. Task-related brain activations decreased over sessions as a function of recovery in a number of primary and non-primary motor regions in all patients, but no session effects were seen in the controls. Furthermore, consistent decreases across sessions correlating with recovery were seen across the whole patient group independent of rate of recovery or initial severity, in primary motor cortex, premotor and prefrontal cortex, supplementary motor areas, cingulate sulcus, temporal lobe, striate cortex, cerebellum, thalamus and basal ganglia. Although recovery-related increases were seen in different brain regions in four patients, there were no consistent effects across the group. These results further our understanding of the recovery process by demonstrating for the first time a clear temporal relationship between recovery and task-related activation of the motor system after stroke.

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Citations in the corpus

Dynamic causal modeling of cortical activity from the acute to the chronic stage after stroke (2011, unknown): “However, the neural processes underlying functional activity and their implication for motor recovery are still controversial (Bütefisch et al., 2005; Fridman et al., 2004; Gerloff et al., 2006; Johansen-Berg et al., 2002;Ward et al., 2003).”
Modulating cortical connectivity in stroke patients by rTMS assessed with fMRI and dynamic causal modeling (2010, unknown): “Hence, longitudinal studies employing different modalities and covering the whole period from early post-ischemic changes to the chronic stage are needed in order to explore and evaluate the development of pathological interactions after stroke (Ward et al., 2003).”
The plastic human brain cortex. (2005, background): “Application of slow, repetitive TMS to the contralateral M1 (presumed to suppress neuronal firing; Walsh & Pascual-Leone 2003) results in increased activation of the rostral SMA and of M1 ipsilateral to the moving hand.”
Why use a connectivity-based approach to study stroke and recovery of function? (2012, unknown): “Task-based functional neuroimaging has been used to study recovery of function (Corbetta et al., 2005; Saur et al., 2006; Ward et al., 2003) and has provided important information on the patterns of functional reorganization post-stroke in several domains including motor (Loubinoux 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.”
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).”
Plasticity during stroke recovery: from synapse to behaviour (2009, background): “However, an emerging consensus from human imaging studies is that the most successful recovery occurs in individuals that exhibit relatively normal lateralized patterns of sensory activation in the hemisphere in which the stroke has taken place, whereas patients with larger strokes, who often show b”
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,”