Reorganization of Sensory and Motor Systems in Hemiplegic Stroke Patients
- 1 August 1999
- journal article
- research article
- Published by Ovid Technologies (Wolters Kluwer Health) in Stroke
- Vol. 30 (8), 1510-1516
- https://doi.org/10.1161/01.str.30.8.1510
Abstract
Background and Purpose—Cortical reorganization of motor systems has been found in recovered stroke patients. Reorganization in nonrecovered hemiplegic stroke patients early after stroke, however, is less well described. We used positron emission tomography to study the functional reorganization of motor and sensory systems in hemiplegic stroke patients before motor recovery. Methods—Regional cerebral blood flow (rCBF) was measured in 6 hemiplegic stroke patients with a single, subcortical infarct and 3 normal subjects with the [15O]H2O injection technique. Brain activation was achieved by passive elbow movements driven by a torque motor. Increases of rCBF comparing passive movements and rest were assessed with statistical parametric mapping. Significant differences were defined at PResults—In normal subjects, significant increases of rCBF were found in the contralateral sensorimotor cortex, supplementary motor area, cingulate cortex, and bilaterally in the inferior parietal cortex. In stroke patients, significant activation was observed bilaterally in the inferior parietal cortex and in the contralateral sensorimotor cortex, ipsilateral prefrontal cortex, supplementary motor area, and cingulate cortex. Significantly larger increases of rCBF in patients compared with normal subjects were found bilaterally in the sensorimotor cortex, stronger in the ipsilateral, unaffected hemisphere, and in both parietal lobes, including the ipsilateral precuneus. Conclusions—Passive movements in hemiplegic stroke patients before clinical recovery elicit some of the brain activation patterns that have been described during active movements after substantial motor recovery. Changes of cerebral activation in sensory and motor systems occur early after stroke and may be a first step toward restoration of motor function after stroke.Keywords
This publication has 29 references indexed in Scilit:
- Event-Related Potentials Elicited by Passive Movements in Humans: Characterization, Source Analysis, and Comparison to fMRINeuroImage, 1998
- The Mental Representation of Hand Movements After Parietal Cortex DamageScience, 1996
- Neural Substrates for the Effects of Rehabilitative Training on Motor Recovery After Ischemic InfarctScience, 1996
- Prolonged muscular flaccidity after stroke Morphological and functional brain alterationsBrain, 1995
- Reorganization of Cortical Representations of the Hand Following Alterations of Skin Inputs Induced by Nerve Injury, Skin Island Transfers, and ExperienceJournal of Hand Therapy, 1993
- Somatosensory Discrimination of Shape: Tactile Exploration and Cerebral ActivationEuropean Journal of Neuroscience, 1991
- Neuronal mechanisms of motor learning in mammalsNeuroReport, 1991
- Thalamic input to inferior area 6 and area 4 in the macaque monkeyJournal of Comparative Neurology, 1989
- Intracortical connectivity of architectonic fields in the somatic sensory, motor and parietal cortex of monkeysJournal of Comparative Neurology, 1978
- SOME COMMENTS ON THE PYRAMIDAL TRACT, WITH SPECIAL REFERENCE TO ITS INDIVIDUAL VARIATIONS IN MANActa Neurologica Scandinavica, 1963