http://nnr.sagepub.com/content/30/1/63?etoc
- Daniel K. Cheung1,2,3
- Seth A. Climans4
- Sandra E. Black, MD, FRCP1,2,3,5
- Fuqiang Gao, MD2
- Gregory M. Szilagyi2,3
- George Mochizuki, PhD1,2,3⇑
- 1Heart and Stroke Foundation Canadian Partnership for Stroke Recovery, Toronto, Ontario, Canada
- 2Sunnybrook Research Institute, Toronto, Ontario, Canada
- 3University of Toronto, Toronto, Ontario, Canada
- 4Western University, London, Ontario, Canada
- 5Sunnybrook Health Sciences Centre, Toronto, Ontario, Canada
- George Mochizuki, Sunnybrook Research Institute, 2075 Bayview Avenue, Rm M6-178, Toronto, Ontario, Canada M4N3M5. Email: george.mochizuki@sunnybrook.ca
Abstract
This study explores the relationship
between lesion location and volume and upper limb spasticity after
stroke. Ninety-seven
stroke patients (51 with spasticity) were included
in the analysis (age = 67.5 ± 13.3 years, 57 males). Lesions were traced
from computed tomography and magnetic resonance
images and coregistered to a symmetrical brain template. Lesion overlays
from
the nonspastic group were subtracted from the
spastic group to determine the regions of the brain more commonly
lesioned in
spastic patients. Similar analysis was performed
across groups of participants whose upper limb (elbow or wrist) Modified
Ashworth Scale (MAS) score ranged from 1 (mild) to 4
(severe). Following subtraction analysis and Fisher’s exact test, the
putamen was identified as the area most frequently
lesioned in individuals with spasticity. More severe spasticity was
associated
with a higher lesion volume. This study establishes
the neuroanatomical correlates of poststroke spasticity and describes
the relationship between lesion characteristics and
the severity of spasticity using mixed brain imaging modalities,
including
computed tomography imaging, which is more readily
available to clinicians. Understanding the association between lesion
location
and volume with the development and severity of
spasticity is an important first step toward predicting the development
of
spasticity after stroke. Such information could
inform the implementation of intervention strategies during the recovery
process
to minimize the extent of impairment. (There are no interventions for spasticity. What the hell are you talking about?)
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