Neural correlates of motor recovery after stroke: a longitudinal fMRI study.
Neural correlates of motor recovery after stroke: a longitudinal fMRI study.
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中风后运动恢复的神经相关性：纵向功能磁共振成像研究。
DOI：
10.1093/brain/awg245
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发表时间：
2003-11
期刊：
影响因子：
--
通讯作者：
Frackowiak RS
中科院分区：
文献类型：
--
作者：
Ward NS;Brown MM;Thompson AJ;Frackowiak RS
中风后运动功能的恢复可能需要数周或数月，通常归因于大脑重组。我们研究了脑卒中后恢复与运动任务相关脑激活之间的纵向关系，采用功能性MRI（fMRI）进行测量。招募了8名首次中风患者，他们表现为脑梗死导致的偏瘫，保留了初级运动皮层，并招募了4名对照受试者。受试者进行了扫描，同时进行等长动态视觉节奏的手握任务的次数。在每个时间点使用一组结局指标评估患者组的恢复情况。在所有患者中，任务相关的大脑激活随着一些主要和非主要运动区域的恢复而减少，但在对照组中没有观察到会话效应。此外，在整个患者组中观察到与恢复相关的持续降低，与恢复率或初始严重程度无关，主要运动皮层、运动前区和前额叶皮层、辅助运动区、扣带回沟、颞叶、纹状体皮层、小脑、丘脑和基底神经节。虽然在四名患者的不同大脑区域观察到恢复相关的增加，但在整个组中没有一致的影响。这些结果通过首次展示中风后运动系统的恢复和任务相关激活之间的明确时间关系，进一步加深了我们对恢复过程的理解。
Recovery of motor function after stroke may occur over weeks or months and is often attributed to cerebral reorganization. We have investigated the longitudinal relationship between recovery after stroke and task-related brain activation during a motor task as measured using functional MRI (fMRI). Eight first-ever stroke patients presenting with hemiparesis resulting from cerebral infarction sparing the primary motor cortex, and four control subjects were recruited. Subjects were scanned on a number of occasions whilst performing an isometric dynamic visually paced hand grip task. Recovery in the patient group was assessed using a battery of outcome measures at each time point. Task-related brain activations decreased over sessions as a function of recovery in a number of primary and non-primary motor regions in all patients, but no session effects were seen in the controls. Furthermore, consistent decreases across sessions correlating with recovery were seen across the whole patient group independent of rate of recovery or initial severity, in primary motor cortex, premotor and prefrontal cortex, supplementary motor areas, cingulate sulcus, temporal lobe, striate cortex, cerebellum, thalamus and basal ganglia. Although recovery-related increases were seen in different brain regions in four patients, there were no consistent effects across the group. These results further our understanding of the recovery process by demonstrating for the first time a clear temporal relationship between recovery and task-related activation of the motor system after stroke.
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