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(Stroke. 2007;38:2032.)
© 2007 American Heart Association, Inc.

Editorials

Can fMRI Measures of Brain Motor Activation Add Significantly to Other Variables in the Prediction of Treatment Response?

Isabelle Loubinoux, PhD

From INSERM U225, Pavillon Riser, Purpan Hospital, Toulouse, France, and Université Paul-Sabatier, Toulouse, France.

Correspondence to Isabelle Loubinoux, INSERM U 825, Pavillon Riser, Hôpital Purpan, 31059 Toulouse, France. E-mail Isabelle.Loubinoux@toulouse.inserm.fr

Key Words: FMRI

An extract of the first 250 words of the full text is provided, because this article has no abstract.

See related article, pages 2108–2114.

This study is among the first to address the basic question of whether fMRI measures of brain motor activation can add significantly to other variables in the prediction of treatment response. The study attempts to use baseline variables in a cohort of 24 chronic stroke patients to predict response to a specific form of rehabilitation, 6 weeks of rehabilitation therapy that targeted arm motor function, especially distally. Patients were also randomized and either did or did not undergo motor cortex electrical stimulation, but the evaluation of this treatment was not the purpose of this study.

This work presents evidence of the use of fMRI as a useful tool to help predicting the responsiveness to an intervention aimed to improve arm motor function. It applies to patients able to mobilize the hand (active wrist extension of at least 5 degrees) and a measurable activation in the ipsilesional primary motor cortex (iM1). It is examining whether fMRI data can predict outcome, but crucially whether it can predict outcome over and above other scores. Only 2 variables out of 13 remain at the end of the analyses: degree of hand motor cortex activation and level of arm Fugl-Meyer score. Authors conclude that fMRI, in particular the degree of activation averaged in a region of interest encompassing the hand area, could help in the decision-making process for allocating patients to a therapeutic regime.

More precisely, the current results suggest that clinical evaluation of arm function predicts higher gain . . . [Full Text of this Article]

Related Article:

Predicting Functional Gains in a Stroke Trial

Steven C. Cramer, Todd B. Parrish, Robert M. Levy, Glenn T. Stebbins, Sean D. Ruland, David W. Lowry, Theodore P. Trouard, Scott W. Squire, Martin E. Weinand, Cary R. Savage, Steven B. Wilkinson, Jenifer Juranek, Szu-Yun Leu, and David M. Himes
Stroke 2007 38: 2108-2114. [Abstract] [Full Text] [PDF]