Hand motor cortical area reorganization in stroke

Rossini, Paolo Maria; Caltagirone, Carlo; Castriota-Scanderbeg, Alessandro; Cicinelli, Paola; Gratta, Cosimo Del; Demartin, M.; Pizzella, Vittorio; Traversa, R.; Romani, Gian Luca

doi:10.1097/00001756-199806220-00043

Cited by 178 publications

(93 citation statements)

References 4 publications

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“…There is some evidence that such changes may occur after stroke as well. 16,17 The notion that local changes in the primary SMC may contribute to recovery is consistent with studies of motor learning in humans. For example, the work of Karni et al 18 has shown that with improved performance on a complex motor task, there is an expansion of the representation for finger movements in the primary SMC.…”

supporting

confidence: 69%

“…14,15 Preliminary data from a few patients have suggested that this might also occur in stroke. 16,17 There did not appear to be a relationship between the degree of functional deficit and the extent of the posterior shift in the geometric center of the SMC activation cluster, Figure 3. Anterior-posterior values (y-axis) of geometric centers of activation clusters in the contralateral primary SMC for individual patients (squares) performing sequential (A) and hand-tapping (B) tasks, given in Talairach coordinates.…”

Section: Discussionmentioning

confidence: 92%

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Functional MRI Detects Posterior Shifts in Primary Sensorimotor Cortex Activation After Stroke

Piñeiro

Pendlebury

Johansen‐Berg

et al. 2001

Stroke

199

116

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Background and Purpose-Further recovery from stroke can occur late, long after the end of the apparent evolution of pathological changes. This observation and evidence obtained from functional imaging for altered patterns of activation after brain injury suggest that cortical reorganization may contribute to recovery. Here, we have tested for potentially adaptive reorganization in the primary sensorimotor cortex. Methods-We used functional MRI to study brain activation with dominant hand movement in right-handed healthy control subjects (nϭ20) and in patients after subcortical ischemic infarcts causing mild to moderate right hemiparesis (nϭ8). The numbers of pixels activated above threshold and the geometric centers of activation clusters were determined. Results-Although random-effects analysis identified some differences in activation maxima, similar regions of the brain were activated with sequential finger tapping in the patient and control groups. However, consistent with the heterogeneity in the locations, sizes, and times after the infarcts, patterns and magnitudes of activation showed some heterogeneity between patients. Nonetheless, for the group as a whole, there was a decreased motor cortex lateralization index (Ϫ0.1Ϯ0.7 in patients and 0.7Ϯ0.3 in control subjects, Pϭ0.05). The geometric center of activation of the primary sensorimotor cortex activation cluster contralateral to the affected hand in patients was also shifted posteriorly (mean 12 mm, PϽ0.04) relative to that of the control subjects. To confirm the latter observation, the activation response with a simple hand-tapping task was examined in some of the subjects. With this task, there was also a trend (mean 10 mm, Pϭ0.07) toward a more posterior activation in patients. Conclusions-These results confirm altered patterns of activation in the contralateral and ipsilateral primary sensorimotor cortices after recovery from strokes causing hemiparesis. These (and other changes) suggest that modulation of widely distributed parts of the cortical network for motor control may contribute to adaptations leading to functional recovery after stroke.

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supporting

confidence: 69%

Section: Discussionmentioning

confidence: 92%

Functional MRI Detects Posterior Shifts in Primary Sensorimotor Cortex Activation After Stroke

Piñeiro

Pendlebury

Johansen‐Berg

et al. 2001

Stroke

199

116

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“…First weakened body part. With recovery following stroke, demonstrated to be valuable in a rat model, there are now Rossini and co-workers [11,56,61] have demonstrated several clinical trials showing that amphetamine given enlarged and / or relocated TMS maps of the recovering together with physical therapy is better than physical muscles, indicating the probable importance of contralatertherapy alone [17,64]. The mechanism for this drug action al hemisphere plasticity mechanisms in recovery.…”

Section: Mechanisms Of Plasticitymentioning

confidence: 99%

Plasticity of the human motor cortex and recovery from stroke

Hallett

2001

Brain Research Reviews

319

178

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By a variety of mechanisms, the human brain is constantly undergoing plastic changes. Plasticity can be studied with phenomena such as peripheral deafferentation and motor learning. Spontaneous recovery from stroke in the chronic stage likely comes about because of plasticity, and the best recovery seems to result from reorganization in the damaged hemisphere. Knowledge about the physiology of brain plasticity has led to the development of new techniques for rehabilitation. Published by Elsevier Science B. V. Theme: Development and regenerationTopic: Motor systems

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“…Although less effectively than in children (Müller et al, 1999), reorganization may also occur later in life. This may occur into ipsilateral cortex (Lazar et al, 1997;Rossini et al, 1998). When sufficient damage has occurred (Kertesz, Lau, & Polk, 1993), the contralateral hemisphere has also been shown to play a role in recovery from aphasia in adults (Thomas et al, 1997;Karbe et al, 1998;Thulborn et al, 1999).…”

Section: Introductionmentioning

confidence: 99%