Sequential activation brain mapping after subcortical stroke: changes in hemispheric balance and recovery

We prospectively studied 5 patients while they were recovering from left-sided subcortical stroke affecting the cortico-spinal tract, and examined them twice with H215O-PET over several months while performing an identical task with the affected hand. Concomitant motor recovery was assessed by measuring the number of thumb-to-index tappings performed in 15 s at each PET session. Across patients, the hemispheric activation balance tended to shift over time toward the unaffected hemisphere, but the magnitude of this shift was highly variable from patient to patient and significantly correlated with recovery. Thus, in subcortical stroke, a shift of activation balance towards the unaffected hemisphere appears associated with lesser initial recovery and, conversely, the more this physiological balance is maintained over time the better the recovery.

[1]  R N Lemon,et al.  Contralateral and ipsilateral EMG responses to transcranial magnetic stimulation during recovery of arm and hand function after stroke. , 1996, Electroencephalography and clinical neurophysiology.

[2]  C. Calautti,et al.  Effects of Age on Brain Activation During Auditory-Cued Thumb-to-Index Opposition: A Positron Emission Tomography Study , 2001, Stroke.

[3]  Richard S. J. Frackowiak,et al.  The functional anatomy of motor recovery after stroke in humans: A study with positron emission tomography , 1991, Annals of neurology.

[4]  M. Jüptner,et al.  Reorganization of sensory and motor systems in hemiplegic stroke patients. A positron emission tomography study. , 1999, Stroke.

[5]  J. Krakauer,et al.  Evolution of cortical activation during recovery from corticospinal tract infarction. , 2000, Stroke.

[6]  V L Towle,et al.  Functional magnetic resonance studies of the reorganization of the human hand sensorimotor area after unilateral brain injury in the perinatal period. , 1994, Proceedings of the National Academy of Sciences of the United States of America.

[7]  Scott T. Grafton,et al.  Automated image registration: I. General methods and intrasubject, intramodality validation. , 1998, Journal of computer assisted tomography.

[8]  Karl J. Friston,et al.  Functional reorganization of the brain in recovery from striatocapsular infarction in man , 1992, Annals of neurology.

[9]  M. Corbetta,et al.  Neural correlates of recovery from aphasia after damage to left inferior frontal cortex , 2000, Neurology.

[10]  P. Matthews,et al.  Functional MRI Detects Posterior Shifts in Primary Sensorimotor Cortex Activation After Stroke: Evidence of Local Adaptive Reorganization? , 2001, Stroke.

[11]  V. Hömberg,et al.  Reorganization of motor output in the non-affected hemisphere after stroke. , 1997, Brain : a journal of neurology.

[12]  D. Perani,et al.  Recovery of neglect after right hemispheric damage: H2(15)O positron emission tomographic activation study. , 1998, Archives of neurology.

[13]  Georg Leonhardt,et al.  Evolution of functional reorganization in hemiplegic stroke: A serial positron emission tomographic activation study , 1999, Annals of neurology.

[14]  H. Karbe,et al.  Differential capacity of left and right hemispheric areas for compensation of poststroke aphasia , 1999, Annals of neurology.

[15]  Zhaowei Jiang,et al.  Consistency analysis for digitized three-dimensional Talairach's Co-Planner Stereotactic Atlas of the human brain , 1997 .

[16]  H. Freund,et al.  Role of the premotor cortex in recovery from middle cerebral artery infarction. , 1998, Archives of neurology.

[17]  Karl J. Friston,et al.  Individual patterns of functional reorganization in the human cerebral cortex after capsular infraction , 1993, Annals of neurology.

[18]  M. Jüptner,et al.  Arm Training Induced Brain Plasticity in Stroke Studied with Serial Positron Emission Tomography , 2001, NeuroImage.

[19]  K P George,et al.  Cortical language activation in stroke patients recovering from aphasia with functional MRI. , 1999, Stroke.

[20]  B. Rosen,et al.  A functional MRI study of subjects recovered from hemiparetic stroke. , 1997, Stroke.

[21]  D. Collins,et al.  Automatic 3D Intersubject Registration of MR Volumetric Data in Standardized Talairach Space , 1994, Journal of computer assisted tomography.

[22]  M Corbetta,et al.  Preserved speech abilities and compensation following prefrontal damage. , 1996, Proceedings of the National Academy of Sciences of the United States of America.

[23]  Yue Cao,et al.  Pilot study of functional MRI to assess cerebral activation of motor function after poststroke hemiparesis. , 1998, Stroke.

[24]  P. Duncan,et al.  Measurement of Motor Recovery After Stroke: Outcome Assessment and Sample Size Requirements , 1992, Stroke.

[25]  L M Harrison,et al.  Patterns of central motor reorganization in hemiplegic cerebral palsy. , 1993, Brain : a journal of neurology.