Published online before print November 14, 2002, doi: 10.1161/01.STR.0000042660.38883.56
| |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
(Stroke. 2002;33:2881.)
© 2002 American Heart Association, Inc.
Original Contributions |
A Pilot Study of Event-Related Functional Magnetic Resonance Imaging of Monitored Wrist Movements in Patients With Partial Recovery
From the Division of Stroke Medicine (J.N., A.S.), Division of Clinical Neurology (S.E.B.), and Magnetic Resonance Centre, School of Physics and Astronomy (A.M.P., K.K.P., P.A.G.), University of Nottingham, Notttingham, United Kingdom.
Correspondence to Dr Alan Sunderland, School of Psychology, University Park, University of Nottingham, Nottingham NG7 2RD, UK. E-mail alan.sunderland{at}nottingham.ac.uk
Background and Purpose— Previous functional imaging studies of motor recovery after stroke have investigated cerebral activation during periods of repetitive, often complex, movement. This article reports the use of an event-related approach to study activation associated with isolated simple movements (wrist extension). This allows investigation of the pattern of the motor response and corresponding brain activation on a trial-by-trial basis. Patients with partial recovery can be assessed, and allowance can be made for abnormalities in the shape of hemodynamic responses.
Methods— Functional MRI at 3 T was performed during a series of isolated, near-isometric wrist extension movements. A visual tracking procedure was used to elicit forces of 10% and 20% of maximum voluntary contraction. Force output from both wrists was monitored continuously. A voxel-wise procedure was used to fit the optimum hemodynamic response functions in each case.
Results— Three chronic stage patients with partial recovery were successfully scanned and compared with 8 healthy controls. The patients showed well-lateralized motor responses but inaccurate control of force. During movement of the paretic wrist, we observed excessive activation of the ipsilateral primary motor cortex and increased relative activation of the supplementary motor area compared with movement of the nonparetic side. In the primary motor area, hemodynamic responses peaked more quickly on the ipsilateral side in 2 patients for movements of the paretic hand, whereas controls showed the opposite trend.
Conclusions— An event-related approach can be used to study the relationship between motor responses and cerebral activation in patients with partial recovery. These preliminary findings suggest that excessive activation in ipsilateral motor cortex and secondary motor areas remains evident under these tightly controlled conditions and cannot be ascribed to mirror movements or abnormalities in the timing of the blood oxygen level–dependent (BOLD) response. However, close monitoring of motor responses also makes evident continuing impairment in motor skill, which makes comparison with activation in normal controls difficult.
Key Words: magnetic resonance imaging • motor activity • stroke outcome
This article has been cited by other articles:
 |
|
 |
|
  B. J. MacIntosh, W. E. McIlroy, R. Mraz, W. R. Staines, S. E. Black, and S. J. Graham Electrodermal Recording and fMRI to Inform Sensorimotor Recovery in Stroke Patients Neurorehabil Neural Repair, November 1, 2008; 22(6): 728 - 736. [Abstract] [PDF]
|
|
|
|
 |
|
 F. Binkofski and R. J. Seitz Modulation of the BOLD-response in early recovery from sensorimotor stroke Neurology, October 12, 2004; 63(7): 1223 - 1229. [Abstract] [Full Text] [PDF]
|
|