Functional reorganization of sensorimotor cortex in chronic hemispheric ischemic stroke patients with different severity of motor deficit

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Abstract

Motor recovery after ischemic stroke is associated with the neural networks reorganization. fMRI studies of these networks in patients with mild motor deficit showed that activation pattern can be used for the prognosis of functional recovery. However, characteristics and clinical relevance of activation patterns in patients with severe to moderate motor deficit, its effective functioning in patients with different severity of primary sensorimotor system components (corticospinal tract [CST] and primary sensorimotor [SM] cortex) injury were not investigated. Twentyfive chronic hemispheric ischemic stroke patients were studied (13 males, 12 females; median age 38.0±5.9 years). Depending on the severity of hand motor impairment and functional outcome the patients were divided into 3 groups. All patients underwent 1.5 T fMRI (Siemens Avanto) with passive block paradigm of paretic index finger movement (1 Hz frequency). Statistic maps of group activation showed significant differences in groups with different functional outcome: the more severe was motor deficit, the less SM activation volume size in injured hemisphere was seen, and activation cluster center moved towards non-primary motor cortex. The association between the activation volume of SM and structural integrity of CST, assessed by fractional anisotropy index was revealed. Statistic maps of individual activation showed SM activation in injured hemisphere in 38% patients with unfavourable (severe paresis, plegia) and moderate recovery with different physiologic lateralization, that is typical for the group with good recovery (mild and moderate paresis). These data do not allow us to consider the activation pattern as a marker of motor recovery and prognostic factor in patients with severe and moderate motor deficit. Our results showed that sensorimotor networks formation and functioning differ depending on the CST sparing, and its effective work is possible in certain degree CST integrity.

 

About the authors

L. A. Dobrynina

Research center of neurology, Russian Academy of Medical Sciences (Moscow)

Author for correspondence.
Email: platonova@neurology.ru
Russian Federation

E. I. Kremneva

Research center of neurology, Russian Academy of Medical Sciences (Moscow)

Email: platonova@neurology.ru
Russian Federation

R. N. Konovalov

Research center of neurology, Russian Academy of Medical Sciences (Moscow)

Email: platonova@neurology.ru
Russian Federation

A. S. Kadykov

Research center of neurology, Russian Academy of Medical Sciences (Moscow)

Email: platonova@neurology.ru
Russian Federation

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Copyright (c) 2017 Dobrynina L.A., Kremneva E.I., Konovalov R.N., Kadykov A.S.

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