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Lesion location alters brain activation in chronically impaired stroke survivors

Lesion location alters brain activation in chronically impaired stroke survivors
Lesion location alters brain activation in chronically impaired stroke survivors
Recovery of motor function after stroke is associated with reorganization in central motor networks. Functional imaging has demonstrated recovery-dependent alterations in brain activation patterns when compared to healthy controls. These alterations are variable across stroke subjects. Factors identified as contributing to this variability are the degree of functional impairment, the time interval since stroke, and rehabilitative therapies. Here, the hypothesis is tested that lesion location influences the activation patterns. Using functional magnetic resonance imaging, the objective was to characterize similarities or differences in movement-related activation patterns in patients chronically disabled by cortical plus subcortical or subcortical lesions only. Brain activation was mapped during paretic and non-paretic movement in 11 patients with subcortical stroke, in nine patients with stroke involving sensorimotor cortex, and in eight healthy volunteers. Patient groups had similar average motor deficit as measured by a battery of scores and strength measures. Substantial differences between patients groups were found in activation patterns associated with paretic limb movement: Whereas contralateral motor cortex, ipsilateral cerebellum (relative to moving limb), bilateral mesial (cingulate, SMA), and perisylvian regions were active in subcortical stroke, cortical patients recruited only ipsilateral postcentral mesial hemisphere regions, and areas at the rim of the stroke cavity. For both groups, activation in ipsilateral postcentral cortex correlated with motor function; in subcortical stroke, the same was found for mesial and perisylvian regions. Overall, brain activation in cortical stroke was less, while in subcortical patients, more than in healthy controls. For non-paretic movement, activation patterns were similar to control in cortical patients. In subcortical patients, however, activation patterns differed: the activation of non-paretic movement was similar to that of paretic movement (corrected for side). The data demonstrate more differences than similarities in the central control of paretic and non-paretic limb movement in patients chronically disabled by subcortical versus cortical stroke. Whereas standard motor circuitry is utilized in subcortical stroke, alternative networks are recruited after cortical stroke. This finding proposes lesion-specific mechanisms of reorganization. Optimal activation of these distinct networks may require different rehabilitative strategies
924-935
Luft, Andreas R.
7d63411e-0ae7-4b6b-9455-b43ba702238c
Waller, Sandy
b3ff4a99-1952-46a8-8dbb-1865d1c6c376
Forrester, Larry
f4cb091c-9475-40df-a515-0207765cecf9
Smith, Gerald V.
628e692d-7c60-4129-9a6f-ca18b5d2daf6
Whitall, Jill
9761aefb-be80-4270-bc1f-0e726399376e
Macko, Richard F.
facb5e9c-e881-4d59-90d4-1a41509db2fe
Schulz, Jörg B.
f5517b7f-ec31-4c7d-9e5c-e190f3c5fd5e
Hanley, Daniel F.
eedff09c-b115-4f05-bd76-012397e1adbd
Luft, Andreas R.
7d63411e-0ae7-4b6b-9455-b43ba702238c
Waller, Sandy
b3ff4a99-1952-46a8-8dbb-1865d1c6c376
Forrester, Larry
f4cb091c-9475-40df-a515-0207765cecf9
Smith, Gerald V.
628e692d-7c60-4129-9a6f-ca18b5d2daf6
Whitall, Jill
9761aefb-be80-4270-bc1f-0e726399376e
Macko, Richard F.
facb5e9c-e881-4d59-90d4-1a41509db2fe
Schulz, Jörg B.
f5517b7f-ec31-4c7d-9e5c-e190f3c5fd5e
Hanley, Daniel F.
eedff09c-b115-4f05-bd76-012397e1adbd

Luft, Andreas R., Waller, Sandy, Forrester, Larry, Smith, Gerald V., Whitall, Jill, Macko, Richard F., Schulz, Jörg B. and Hanley, Daniel F. (2004) Lesion location alters brain activation in chronically impaired stroke survivors. NeuroImage, 21 (3), 924-935. (doi:10.1016/j.neuroimage.2003.10.026). (PMID:15006659)

Record type: Article

Abstract

Recovery of motor function after stroke is associated with reorganization in central motor networks. Functional imaging has demonstrated recovery-dependent alterations in brain activation patterns when compared to healthy controls. These alterations are variable across stroke subjects. Factors identified as contributing to this variability are the degree of functional impairment, the time interval since stroke, and rehabilitative therapies. Here, the hypothesis is tested that lesion location influences the activation patterns. Using functional magnetic resonance imaging, the objective was to characterize similarities or differences in movement-related activation patterns in patients chronically disabled by cortical plus subcortical or subcortical lesions only. Brain activation was mapped during paretic and non-paretic movement in 11 patients with subcortical stroke, in nine patients with stroke involving sensorimotor cortex, and in eight healthy volunteers. Patient groups had similar average motor deficit as measured by a battery of scores and strength measures. Substantial differences between patients groups were found in activation patterns associated with paretic limb movement: Whereas contralateral motor cortex, ipsilateral cerebellum (relative to moving limb), bilateral mesial (cingulate, SMA), and perisylvian regions were active in subcortical stroke, cortical patients recruited only ipsilateral postcentral mesial hemisphere regions, and areas at the rim of the stroke cavity. For both groups, activation in ipsilateral postcentral cortex correlated with motor function; in subcortical stroke, the same was found for mesial and perisylvian regions. Overall, brain activation in cortical stroke was less, while in subcortical patients, more than in healthy controls. For non-paretic movement, activation patterns were similar to control in cortical patients. In subcortical patients, however, activation patterns differed: the activation of non-paretic movement was similar to that of paretic movement (corrected for side). The data demonstrate more differences than similarities in the central control of paretic and non-paretic limb movement in patients chronically disabled by subcortical versus cortical stroke. Whereas standard motor circuitry is utilized in subcortical stroke, alternative networks are recruited after cortical stroke. This finding proposes lesion-specific mechanisms of reorganization. Optimal activation of these distinct networks may require different rehabilitative strategies

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Published date: March 2004
Organisations: Faculty of Health Sciences

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Local EPrints ID: 361338
URI: http://eprints.soton.ac.uk/id/eprint/361338
PURE UUID: cbb32564-a59c-4530-a33c-e14ce4a14a79

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Date deposited: 17 Jan 2014 14:36
Last modified: 16 Jul 2019 21:14

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Contributors

Author: Andreas R. Luft
Author: Sandy Waller
Author: Larry Forrester
Author: Gerald V. Smith
Author: Jill Whitall
Author: Richard F. Macko
Author: Jörg B. Schulz
Author: Daniel F. Hanley

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