Early imaging correlates of subsequent motor recovery after stroke.
Ann Neurol
; 65(5): 596-602, 2009 May.
Article
em En
| MEDLINE
| ID: mdl-19479972
ABSTRACT
OBJECTIVE:
To determine whether functional magnetic resonance imaging activation obtained in the first few days after stroke correlates with subsequent motor recovery.METHODS:
Twenty-three patients with hemiparesis after first-time stroke were scanned at 2.0 +/- 0.9 days while performing a simple motor task. We defined recovery as the change in Fugl-Meyer score from time of scan to approximately 3 months later (90 +/- 8 days). We performed three different tests to assess correlations between brain activation and change in Fugl-Meyer score (1) multivariate (most sensitive to spatially diffuse activation); (2) voxel-wise Statistical Parametric Mapping (most sensitive to focal activation), and (3) primary motor cortex region-of-interest analysis (most sensitive to average activation within this region). All tests controlled for initial stroke severity and lesion volume, as well as other established clinical variables.RESULTS:
The multivariate test was significant [F (595, 4,934) = 1.93; p < 0.001]. The Statistical Parametric Mapping test detected two small clusters of focal activity located in the ipsilesional postcentral gyrus and cingulate cortex (p < 0.05, corrected). The region-of-interest test was not significant.INTERPRETATION:
There is a pattern of brain activation present in the first few days after stroke, of which the postcentral gyrus and cingulate cortex are a part, that correlates with subsequent motor recovery. This result suggests that there are recovery processes engaged early after stroke that could provide a target for intervention.
Texto completo:
1
Coleções:
01-internacional
Base de dados:
MEDLINE
Assunto principal:
Encéfalo
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Imageamento por Ressonância Magnética
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Recuperação de Função Fisiológica
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Acidente Vascular Cerebral
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Transtornos dos Movimentos
Tipo de estudo:
Observational_studies
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Risk_factors_studies
Limite:
Adult
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Aged
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Female
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Humans
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Male
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Middle aged
Idioma:
En
Revista:
Ann Neurol
Ano de publicação:
2009
Tipo de documento:
Article