Published Online
on November 23, 2005

A more recent version of this article appeared on January 1, 2006

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Submitted on August 19, 2005
Revised on October 7, 2005
Accepted on October 12, 2005

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

Steven C. Cramer MD^*; Rajendra Shah BSc; Jenifer Juranek PhD; Kit R. Crafton BS; and Vu Le MS

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.

^* To whom correspondence should be addressed. 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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