Document Detail


Brain activation of lower extremity movement in chronically impaired stroke survivors.
MedLine Citation:
PMID:  15862218     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Lower extremity paresis poses significant disability to chronic stroke survivors. Unlike for the upper extremity, cortical adaptations in networks controlling the paretic leg have not been characterized after stroke. Here, the hypotheses are that brain activation associated with unilateral knee movement in chronic stroke survivors is abnormal, depends on lesion location, and is related to walking ability. Functional magnetic resonance imaging of unilateral knee movement was obtained in 31 patients 26.9 months (mean, IQ range: 11.3-68.1) after stroke and in 10 age-matched healthy controls. Strokes were stratified according to lesion location. Locomotor disability (30 ft walking speed) did not differ between patient groups (9 cortical, 12 subcortical, 10 brainstem lesions). Significant differences in brain activation as measured by voxel counts in 10 regions of interest were found between controls and patients with brainstem (P = 0.006) and cortical strokes (P = 0.002), and between subcortical and cortical patients (P = 0.026). Statistical parametric mapping of data per group revealed similar activation patterns in subcortical patients and controls with recruitment of contralateral primary motor cortex (M1), supplementary motor area (SMA), and bilateral somatosensory area 2 (S2). Cortical recruitment was reduced in brainstem and cortical stroke. Better walking was associated with lesser contralateral sensorimotor cortex activation in brainstem, but stronger recruitment of ipsilateral sensorimotor and bilateral somatosensory cortices in subcortical and cortical patients, respectively. A post hoc comparison of brainstem patients with and without mirror movements (50%) revealed lesser recruitment of ipsilateral cerebellum in the latter. Subcortical patients with mirror movements (58%) showed lesser bilateral sensorimotor cortex activation. No cortical patient had mirror movements. The data reveal adaptations in networks controlling unilateral paretic knee movement in chronic stroke survivors. These adaptations depend on lesion location and seem to have functional relevance for locomotion.
Authors:
Andreas R Luft; Larry Forrester; Richard F Macko; Sandy McCombe-Waller; Jill Whitall; Federico Villagra; Daniel F Hanley
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Publication Detail:
Type:  Journal Article; Research Support, N.I.H., Extramural; Research Support, Non-U.S. Gov't; Research Support, U.S. Gov't, P.H.S.    
Journal Detail:
Title:  NeuroImage     Volume:  26     ISSN:  1053-8119     ISO Abbreviation:  Neuroimage     Publication Date:  2005 May 
Date Detail:
Created Date:  2005-05-02     Completed Date:  2005-07-12     Revised Date:  2007-11-15    
Medline Journal Info:
Nlm Unique ID:  9215515     Medline TA:  Neuroimage     Country:  United States    
Other Details:
Languages:  eng     Pagination:  184-94     Citation Subset:  IM    
Affiliation:
Division of Brain Injury Outcomes, Department of Neurology, Johns Hopkins University, Baltimore, MD 21218, USA. aluft@jhu.edu
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MeSH Terms
Descriptor/Qualifier:
Aged
Brain / physiopathology*
Brain Mapping
Brain Stem / physiopathology
Chronic Disease
Electromyography
Female
Functional Laterality / physiology
Gait Disorders, Neurologic / etiology,  physiopathology*
Humans
Image Processing, Computer-Assisted
Knee / physiopathology
Lower Extremity / innervation,  physiopathology*
Magnetic Resonance Imaging
Male
Middle Aged
Motor Cortex / physiopathology
Movement / physiology*
Paralysis / physiopathology
Stroke / complications,  physiopathology*
Walking / physiology
Grant Support
ID/Acronym/Agency:
1R01 NS 24282-08/NS/NINDS NIH HHS; M01 RR-00052/RR/NCRR NIH HHS; P60AG 12583/AG/NIA NIH HHS

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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