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(Stroke. 2006;37:111.)
© 2006 American Heart Association, Inc.

Original Contributions

Activity in the Peri-Infarct Rim in Relation to Recovery From Stroke

From the Department of Neurology (S.C.C., K.R.C.), University of Washington, Seattle; and Departments of Neurology, and Anatomy and Neurobiology, and the General Clinical Research Center (S.C.C., R.S., J.J., V.L.), University of California, Irvine.

Correspondence to Steven C. Cramer, MD, University of California, Irvine, UCI Medical Center, 101 The City Dr S, Building 53 Room 203, Orange, CA 92868-4280. E-mail scramer{at}uci.edu

Background and Purpose— In the rim of tissue surrounding a cortical infarct, animal studies have described an increase in a number of growth-related processes that likely contribute to behavioral recovery. The current study hypothesized that in patients with good outcome after stroke, brain activation in peri-infarct tissue would be greater than normal.

Methods— In 15 patients with good recovery chronically after ischemic cortical stroke, activation within peri-infarct brain tissue was directly compared with activation within the same brain tissue of 13 control subjects.

Results— Although most patients did show activation within peri-infarct tissues, their activation compared with controls was reduced rather than increased. Evaluation of the T2*-weighted images underlying functional MRI mapping disclosed a significant gradient of increased T2* signal in peri-infarct tissues, likely attributable to tissue changes such as gliosis.

Conclusions— Among well-recovered stroke patients, cortical activation is present in the area surrounding a cortical infarct but is smaller than normal. A baseline derangement of the T2*-weighted signal underlying functional MRI (fMRI) is also present in this area, which might influence interpretation of fMRI findings. The relationship between increased tissue T2* signal and fMRI activation is not known and requires further study.

Key Words: functional MRI • motor activity • neuronal plasticity • stroke

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