A Functional MRI Study of Three Motor Tasks in the Evaluation of Stroke Recovery

2001 ◽  
Vol 15 (1) ◽  
pp. 1-8 ◽  
Author(s):  
Steven C. Cramer ◽  
Gereon Nelles ◽  
Judith D. Schaechter ◽  
Jill D. Kaplan ◽  
Seth P. Finklestein ◽  
...  
Keyword(s):  
Functional Mri ◽  
Sensorimotor Cortex ◽  
Index Finger ◽  
Motor Recovery ◽  
Functional Brain Imaging ◽  
Stroke Recovery ◽  
Finger Tapping ◽  
Motor Tasks ◽  
Stroke Patients ◽  
Control Subjects

Functional brain imaging studies have provided insights into the processes related to motor recovery after stroke. The comparative value of different motor activation tasks for probing these processes has received limited study. We hypothesized that dif ferent hand motor tasks would activate the brain differently in controls, and that this would affect control-patient comparisons. Functional magnetic resonance imaging (MRI) was used to evaluate nine control subjects and seven patients with good recov ery after a left hemisphere hemiparetic stroke. The volume of activated brain in bilat eral sensorimotor cortex and four other motor regions was compared during each of three tasks performed by the right hand: index finger tapping, four-finger tapping, and squeezing. In control subjects, activation in left sensorimotor cortex was found to be significantly larger during squeezing as compared with index-finger tapping. When com paring control subjects with stroke patients, patients showed a larger volume of acti vation in right sensorimotor cortex during index-finger tapping but not with four-fin ger tapping or squeezing. In addition, patients also showed a trend toward larger activation volume than controls within left supplementary motor area during index- finger tapping but not during the other tasks. Motion artifact was more common with squeezing than with the tapping tasks. The choice of hand motor tasks used during brain mapping can influence findings in control subjects as well as the differences identified between controls and stroke patients. The results may be useful for future studies of motor recovery after stroke. Key Words: Stroke—Motor recovery—Functional MRI.

Activation of Distinct Motor Cortex Regions During Ipsilateral and Contralateral Finger Movements

1999 ◽  
Vol 81 (1) ◽  
pp. 383-387 ◽  
Author(s):  
Steven C. Cramer ◽  
Seth P. Finklestein ◽  
Judith D. Schaechter ◽  
George Bush ◽  
Bruce R. Rosen
Keyword(s):  
Motor Cortex ◽  
Index Finger ◽  
Hand Movement ◽  
Stroke Recovery ◽  
Finger Tapping ◽  
Hand Movements ◽  
Precentral Gyrus ◽  
Finger Movements ◽  
Stroke Patients ◽  
Contralateral Hand

Cramer, Steven C., Seth P. Finklestein, Judith D. Schaechter, George Bush, and Bruce R. Rosen. Activation of distinct motor cortex regions during ipsilateral and contralateral finger movements. J. Neurophysiol. 81: 383–387, 1999. Previous studies have shown that unilateral finger movements are normally accompanied by a small activation in ipsilateral motor cortex. The magnitude of this activation has been shown to be altered in a number of conditions, particularly in association with stroke recovery. The site of this activation, however, has received limited attention. To address this question, functional magnetic resonance imaging (MRI) was used to study precentral gyrus activation in six control and three stroke patients during right index finger tapping, then during left index finger tapping. In each hemisphere, the most significantly activated site ( P < 0.001 required) was identified during ipsilateral and during contralateral finger tapping. In the motor cortex of each hemisphere, the site activated during use of the ipsilateral hand differed from that found during use of the contralateral hand. Among the 11 control hemispheres showing significant activation during both motor tasks, the site for ipsilateral hand representation (relative to contralateral hand site in the same hemisphere) was significantly shifted ventrally in all 11 hemispheres (mean, 11 mm), laterally in 10/11 hemispheres (mean, 12 mm), and anteriorly in 8/11 hemispheres (mean, 10 mm). In 6 of 11 hemispheres, tapping of the contralateral finger simultaneously activated both the ipsilateral and the contralateral finger sites, suggesting bilateral motor control by the ipsilateral finger site. The sites activated during ipsilateral and contralateral hand movement showed similar differences in the unaffected hemisphere of stroke patients. The region of motor cortex activated during ipsilateral hand movements is spatially distinct from that identified during contralateral hand movements.

scholarly journals Explicit motor sequence learning after stroke: a neuropsychological study

2021 ◽  
Author(s):  
Cristina Russo ◽  
Laura Veronelli ◽  
Carlotta Casati ◽  
Alessia Monti ◽  
Laura Perucca ◽  
...  
Keyword(s):  
Basal Ganglia ◽  
Motor Learning ◽  
Upper Limb ◽  
Motor Recovery ◽  
Finger Tapping ◽  
Control Group ◽  
Stroke Severity ◽  
Motor Sequence ◽  
Stroke Patients ◽  
Motor Practice

AbstractMotor learning interacts with and shapes experience-dependent cerebral plasticity. In stroke patients with paresis of the upper limb, motor recovery was proposed to reflect a process of re-learning the lost/impaired skill, which interacts with rehabilitation. However, to what extent stroke patients with hemiparesis may retain the ability of learning with their affected limb remains an unsolved issue, that was addressed by this study. Nineteen patients, with a cerebrovascular lesion affecting the right or the left hemisphere, underwent an explicit motor learning task (finger tapping task, FTT), which was performed with the paretic hand. Eighteen age-matched healthy participants served as controls. Motor performance was assessed during the learning phase (i.e., online learning), as well as immediately at the end of practice, and after 90 min and 24 h (i.e., retention). Results show that overall, as compared to the control group, stroke patients, regardless of the side (left/right) of the hemispheric lesion, do not show a reliable practice-dependent improvement; consequently, no retention could be detected in the long-term (after 90 min and 24 h). The motor learning impairment was associated with subcortical damage, predominantly affecting the basal ganglia; conversely, it was not associated with age, time elapsed from stroke, severity of upper-limb motor and sensory deficits, and the general neurological condition. This evidence expands our understanding regarding the potential of post-stroke motor recovery through motor practice, suggesting a potential key role of basal ganglia, not only in implicit motor learning as previously pointed out, but also in explicit finger tapping motor tasks.

scholarly journals 2190 Longitudinal changes in EEG power envelope connectivity are proportional to motor recovery in chronic stroke patients

2018 ◽  
Vol 2 (S1) ◽  
pp. 17-17
Author(s):  
Joseph B. Humphries ◽  
David T. Bundy ◽  
Eric C. Leuthardt ◽  
Thy N. Huskey
Keyword(s):  
Motor Cortex ◽  
Motor Imagery ◽  
Stroke Rehabilitation ◽  
Brain Computer Interface ◽  
Chronic Stroke ◽  
Motor Recovery ◽  
Stroke Recovery ◽  
Computer Interface ◽  
Beta Band ◽  
Stroke Patients

OBJECTIVES/SPECIFIC AIMS: The objective of this study is to determine the degree to which the use of a contralesionally-controlled brain-computer interface for stroke rehabilitation drives change in interhemispheric motor cortical activity. METHODS/STUDY POPULATION: Ten chronic stroke patients were trained in the use of a brain-computer interface device for stroke recovery. Patients perform motor imagery to control the opening and closing of a motorized hand orthosis. This device was sent home with patients for 12 weeks, and patients were asked to use the device 1 hour per day, 5 days per week. The Action Research Arm Test (ARAT) was performed at 2-week intervals to assess motor function improvement. Before the active motor imagery task, patients were asked to quietly rest for 90 seconds before the task to calibrate recording equipment. EEG signals were acquired from 2 electrodes—one each centered over left and right primary motor cortex. Signals were preprocessed with a 60 Hz notch filter for environmental noise and referenced to the common average. Power envelopes for 1 Hz frequency bands (1–30 Hz) were calculated through Gabor wavelet convolution. Correlations between electrodes were then calculated for each frequency envelope on the first and last 5 runs, thus generating one correlation value per subject, per run. The chosen runs approximately correspond to the first and last week of device usage. These correlations were Fisher Z-transformed for comparison. The first and last 5 run correlations were averaged separately to estimate baseline and final correlation values. A difference was then calculated between these averages to determine correlation change for each frequency. The relationship between beta-band correlation changes (13–30 Hz) and the change in ARAT score was determined by calculating a Pearson correlation. RESULTS/ANTICIPATED RESULTS: Beta-band inter-electrode correlations tended to decrease more in patients achieving greater motor recovery (Pearson’s r=−0.68, p=0.031). A similar but less dramatic effect was observed with alpha-band (8–12 Hz) correlation changes (Pearson’s r=−0.42, p=0.22). DISCUSSION/SIGNIFICANCE OF IMPACT: The negative correlation between inter-electrode power envelope correlations in the beta frequency band and motor recovery indicates that activity in the motor cortex on each hemisphere may become more independent during recovery. The role of the unaffected hemisphere in stroke recovery is currently under debate; there is conflicting evidence regarding whether it supports or inhibits the lesioned hemisphere. These findings may support the notion of interhemispheric inhibition, as we observe less in common between activity in the 2 hemispheres in patients successfully achieving recovery. Future neuroimaging studies with greater spatial resolution than available with EEG will shed further light on changes in interhemispheric communication that occur during stroke rehabilitation.

Abstract 2806: Does Motor Cortex Activity Predict Motor Recovery? An fMRI Study of Subacute Lacunar Stroke

Stroke ◽  
2012 ◽  
Vol 43 (suppl_1) ◽  
Author(s):  
Assia Jaillard ◽  
Chantal Delon martin ◽  
Leeanne Carey ◽  
Laurent Lalamalle ◽  
Marc J Hommel ◽  
...  
Keyword(s):  
Motor Cortex ◽  
Primary Motor Cortex ◽  
Motor Recovery ◽  
Small Sample ◽  
Stroke Onset ◽  
Stroke Recovery ◽  
Finger Tapping ◽  
Lacunar Stroke ◽  
Related Activity ◽  
Recovery Score

Background: While primary motor cortex (M1) has been demonstrated to be crucial for motor recovery in a recent meta-analysis including fMRI and TMS studies, other functional neuroimaging studies have found that activity in a broader sensorimotor cortical network correlate with motor recovery. The heterogeneity of stroke lesions and the small sample size characterizing many studies could account for these discrepancies. Hypothesis : The strength of task-related activity in primary motor cortex predicts motor recovery in a clinically homogenous population of acute lacunar stroke patients. Methods: We used fMRI to investigate the neural mechanisms of stroke recovery. We studied 18 stroke patient (4 females, 14 males) after their first single lacunar stroke (7 right , 11 left hemisphere). The lesions caused pure hemiparesia one week after stroke onset (mean 7.2 days; range 2 -15). Lesions were limited to the deep territory of the anterior choroid artery, involving the corticospinal tract at the level of the internal capsule or the corona radiata ( Figure 1 ). Patients were matched to 18 healthy controls for age and sex. Motor impairment was assessed using the NIH Stroke Scale (NIHSS), the Fugl-Meyer Scale (FMS), Finger Tapping Score (FTS), Purdue Pegboard and simple reaction times 7 days and 6 months after stroke. At 6 months, a global motor recovery score was computed using the FMS and the FTS to assess motor recovery. Functional MRI scans were obtained using a self-paced finger tapping (FT) task implemented as a block design alternating right FT, left FT and rest. Data were processed using SPM8. In the first level analysis “FT minus fixation” contrasts were computed for the impaired hand. At the second level, multiple regression was used to assess the effect of the motor recovery score on the FT-related motor activity (threshold p<0.05 FWE; extent threshold k=5). Age and FT rate recorded during the experiment were included as covariates in the second level model. Results: As a group, the patients showed good recovery at 6 months. Both patients and controls exhibited a typical pattern of FT task-related activity. Activity in primary motor cortex predicted motor recovery at 6 months, after adjustment for age and FT rate. MNI coordinates = [-34,-14,48] See Figure 1 . Conclusions: Primary motor cortex activity, measured soon after stroke onset, predicts motor recovery assessed at 6 months post-stroke. fMRI measurements made in the early phase of stroke recovery could be useful to derive prognostic biomarkers in both clinical practice and clinical trials investigating novel treatments, such as stem cell administration.

The Effectiveness of Mirror Therapy to Upper Extremity Rehabilitation in Acute Stroke Patients

2021 ◽  
Author(s):  
Phassakorn Klinkwan ◽  
Chalunda Kongmaroeng ◽  
Sombat Muengtaweepongsa ◽  
Wiroj Limtrakarn
Keyword(s):  
Acute Stroke ◽  
Upper Extremity ◽  
Upper Limb ◽  
Conventional Therapy ◽  
Motor Recovery ◽  
Stroke Recovery ◽  
Home Exercise ◽  
Control Group ◽  
Mirror Therapy ◽  
Stroke Patients

Rehabilitation is a crucial part of stroke recovery to help them regain use of their limb. The aim of this article was to compare the effectiveness of long-term training of mirror therapy with conventional rehabilitation therapy on neurological and recovery of upper limb in acute stroke patients. In this randomized and assessor-blinded control study, 20 acute stroke patients were analyzed in this study and allocated to a case (n = 10, 50.6 ± 17.90 years) and control group (n = 10, 55.9 ± 11.25 years). All the participants performed daily home exercise during 12 weeks. The patients in the control group were treated with conventional therapy (CT) and a group of cases were treated with mirror therapy (MT) alone program. The outcome measurements were assessed by a therapist blinded assessor using Fugl-Meyer Assessment (FMA) upper extremity score, Brunnstrom recovery stages (BRS), Modified Ashworth Scale (MAS) and Muscle Strength to evaluate upper limb motor function and motor recovery. Data were analyzed using Wilcoxon and Mann-Whitney U tests to compare within-groups and between-group differences. The results revealed that, after 12 weeks of treatment, patients of both groups presented statistically significant improvements in all the variables measured (p < 0.05). Compared with the control group, the patients of the MT group had greater improvement in the proximal movement portion of the FMA upper extremity mean score change (15.8 ± 3.2 versus 10.0 ± 2.7, p = 0.002) while there were no differences in other variables (p > 0.05). There were also no adverse events. It suggests that 12 weeks training of mirror therapy alone was likely to improve the motor recovery of the upper limb and activity of daily living in acute stroke patients than conventional therapy, if treated early.

scholarly journals Subacute Changes in N-Acetylaspartate (NAA) Following Ischemic Stroke: A Serial MR Spectroscopy Pilot Study

Diagnostics ◽  
2020 ◽  
Vol 10 (7) ◽  
pp. 482 ◽  
Author(s):  
Ndaba Mazibuko ◽  
Ruth O’Gorman Tuura ◽  
Laszlo Sztriha ◽  
Owen O’Daly ◽  
Gareth J. Barker ◽  
...  
Keyword(s):  
Ischemic Stroke ◽  
Detrimental Effect ◽  
Neuronal Loss ◽  
Motor Recovery ◽  
Stroke Recovery ◽  
Resonance Spectroscopy ◽  
Stroke Patients ◽  
Acute Ischaemia ◽  
1H Magnetic Resonance Spectroscopy ◽  
Neuronal Tissue

Preservation of neuronal tissue is crucial for recovery after stroke, but studies suggest that prolonged neuronal loss occurs following acute ischaemia. This study assessed the temporal pattern of neuronal loss in subacute ischemic stroke patients using 1H magnetic resonance spectroscopy, in parallel with functional recovery at 2, 6 and 12 weeks after stroke. Specifically, we measured N-acetylaspartate (NAA), choline, myoinositol, creatine and lactate concentrations in the ipsilesional and contralesional thalamus of 15 first-ever acute ischaemic stroke patients and 15 control participants and correlated MRS concentrations with motor recovery, measured at 12 weeks using the Fugl–Meyer scale. NAA in the ipsilesional thalamus fell significantly between 2 and 12 weeks (10.0 to 7.97 mmol/L, p = 0.003), while choline, myoinositol and lactate concentrations increased (p = 0.025, p = 0.031, p = 0.001, respectively). Higher NAA concentrations in the ipsilesional thalamus at 2 and 12 weeks correlated with higher Fugl Meyer scores at 12 weeks (p = 0.004 and p = 0.006, respectively). While these results should be considered preliminary given the modest sample size, the progressive fall in NAA and late increases in choline, myoinositol and lactate may indicate progressive non-ischaemic neuronal loss, metabolically depressed neurons and/or diaschisis effects, which have a detrimental effect on motor recovery. Interventions that can potentially limit this ongoing subacute tissue damage may improve stroke recovery.

scholarly journals Task-related brain functional network reconfigurations relate to motor recovery in chronic subcortical stroke

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Hsiao-Ju Cheng ◽  
Kwun Kei Ng ◽  
Xing Qian ◽  
Fang Ji ◽  
Zhong Kang Lu ◽  
...  
Keyword(s):  
Brain Network ◽  
Cognitive Networks ◽  
Motor Recovery ◽  
Functional Network ◽  
Task Demand ◽  
Motor Tasks ◽  
Stroke Patients ◽  
Post Intervention ◽  
Task Conditions ◽  
Brain Functional Connectivity

AbstractStroke leads to both regional brain functional disruptions and network reorganization. However, how brain functional networks reconfigure as task demand increases in stroke patients and whether such reorganization at baseline would facilitate post-stroke motor recovery are largely unknown. To address this gap, brain functional connectivity (FC) were examined at rest and motor tasks in eighteen chronic subcortical stroke patients and eleven age-matched healthy controls. Stroke patients underwent a 2-week intervention using a motor imagery-assisted brain computer interface-based (MI-BCI) training with or without transcranial direct current stimulation (tDCS). Motor recovery was determined by calculating the changes of the upper extremity component of the Fugl–Meyer Assessment (FMA) score between pre- and post-intervention divided by the pre-intervention FMA score. The results suggested that as task demand increased (i.e., from resting to passive unaffected hand gripping and to active affected hand gripping), patients showed greater FC disruptions in cognitive networks including the default and dorsal attention networks. Compared to controls, patients had lower task-related spatial similarity in the somatomotor–subcortical, default–somatomotor, salience/ventral attention–subcortical and subcortical–subcortical connections, suggesting greater inefficiency in motor execution. Importantly, higher baseline network-specific FC strength (e.g., dorsal attention and somatomotor) and more efficient brain network reconfigurations (e.g., somatomotor and subcortical) from rest to active affected hand gripping at baseline were related to better future motor recovery. Our findings underscore the importance of studying functional network reorganization during task-free and task conditions for motor recovery prediction in stroke.

scholarly journals Acupuncture De Qi in Stable Somatosensory Stroke Patients: Relations with Effective Brain Network for Motor Recovery

2013 ◽  
Vol 2013 ◽  
pp. 1-9 ◽  
Author(s):  
Lijun Bai ◽  
Fangyuan Cui ◽  
Yihuai Zou ◽  
Lixing Lao
Keyword(s):  
Resting State ◽  
Neural Mechanism ◽  
Brain Network ◽  
Motor Recovery ◽  
Stroke Recovery ◽  
Causality Analysis ◽  
Stroke Patients ◽  
Granger Causality Analysis ◽  
Acupuncture Effect ◽  
De Qi

Acupuncture has been widely used for treating stroke and De Qi may play an important role. In spite of its acceptance, the neural mechanism underlying acupuncture for motor recovery is still elusive. Particularly, by what extent De Qi sensations can reliably predict the therapeutical acupuncture effect on the mediating recovery from stroke is urgent to investigate. Nine stroke patients were assessed by De Qi, neurological examination, and scanned with acupuncture stimuli across two time points at an interval of two weeks. And we adopted multivariate Granger causality analysis to explore the interregional influences within motor executive brain network during post-acupuncture resting state. Our findings indicated that acupuncture at GB34 can enhance the recovery of stroke mainly by strengthening causal influences between the ipsilesional and contralesional motor cortex. Moreover, centrality of some motor-related regions correlated with clinical variables and thus served as a predictor of stroke recovery. Along the same line, the centrality of these motor-related regions has also high relations with the De Qi sensation. Our findings suggest that De Qi having relatively stable reliability may be essential and used as a predictor to the therapeutic effectiveness of acupuncture for stroke recovery.

Context-dependent relationship in high-resolution micro-ECoG studies during finger movements

2020 ◽  
Vol 132 (5) ◽  
pp. 1358-1366
Author(s):  
Chao-Hung Kuo ◽  
Timothy M. Blakely ◽  
Jeremiah D. Wander ◽  
Devapratim Sarma ◽  
Jing Wu ◽  
...  
Keyword(s):  
High Resolution ◽  
Sensorimotor Cortex ◽  
Index Finger ◽  
Hand Movement ◽  
Cortical Activation ◽  
Hand Movements ◽  
Finger Movements ◽  
Thumb Movement ◽  
Neurosurgical Patients ◽  
The Relationship

OBJECTIVEThe activation of the sensorimotor cortex as measured by electrocorticographic (ECoG) signals has been correlated with contralateral hand movements in humans, as precisely as the level of individual digits. However, the relationship between individual and multiple synergistic finger movements and the neural signal as detected by ECoG has not been fully explored. The authors used intraoperative high-resolution micro-ECoG (µECoG) on the sensorimotor cortex to link neural signals to finger movements across several context-specific motor tasks.METHODSThree neurosurgical patients with cortical lesions over eloquent regions participated. During awake craniotomy, a sensorimotor cortex area of hand movement was localized by high-frequency responses measured by an 8 × 8 µECoG grid of 3-mm interelectrode spacing. Patients performed a flexion movement of the thumb or index finger, or a pinch movement of both, based on a visual cue. High-gamma (HG; 70–230 Hz) filtered µECoG was used to identify dominant electrodes associated with thumb and index movement. Hand movements were recorded by a dataglove simultaneously with µECoG recording.RESULTSIn all 3 patients, the electrodes controlling thumb and index finger movements were identifiable approximately 3–6-mm apart by the HG-filtered µECoG signal. For HG power of cortical activation measured with µECoG, the thumb and index signals in the pinch movement were similar to those observed during thumb-only and index-only movement, respectively (all p > 0.05). Index finger movements, measured by the dataglove joint angles, were similar in both the index-only and pinch movements (p > 0.05). However, despite similar activation across the conditions, markedly decreased thumb movement was observed in pinch relative to independent thumb-only movement (all p < 0.05).CONCLUSIONSHG-filtered µECoG signals effectively identify dominant regions associated with thumb and index finger movement. For pinch, the µECoG signal comprises a combination of the signals from individual thumb and index movements. However, while the relationship between the index finger joint angle and HG-filtered signal remains consistent between conditions, there is not a fixed relationship for thumb movement. Although the HG-filtered µECoG signal is similar in both thumb-only and pinch conditions, the actual thumb movement is markedly smaller in the pinch condition than in the thumb-only condition. This implies a nonlinear relationship between the cortical signal and the motor output for some, but importantly not all, movement types. This analysis provides insight into the tuning of the motor cortex toward specific types of motor behaviors.

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