http://stroke.ahajournals.org/content/47/2/482.abstract?etoc
- Robert Schulz, MD;
- Anika Buchholz, PhD;
- Benedikt M. Frey, MS;
- Marlene Bönstrup, MD;
- Bastian Cheng, MD;
- Götz Thomalla, MD;
- Friedhelm C. Hummel, MD;
- Christian Gerloff, MD
+ Author Affiliations
- Correspondence to Christian Gerloff, MD, Department of Neurology, University Medical Center Hamburg-Eppendorf Martinistr. 52, 20246 Hamburg, Germany. E-mail gerloff@uke.de
Abstract
Background and Purpose—Ischemic
strokes with motor deficits lead to widespread changes in neural
activity and interregional coupling between primary
and secondary motor areas. Compared with
frontal circuits, the knowledge is still limited to what extent parietal
cortices
and their interactions with frontal motor
areas undergo plastic changes and might contribute to residual motor
functioning
after stroke.
Methods—Fifteen
well-recovered patients were evaluated 3 months after stroke by means of
functional magnetic resonance imaging while
performing visually guided hand grips with
their paretic hand. Dynamic causal modeling was used to investigate
task-related
effective connectivity between ipsilesional
posterior parietal regions along the intraparietal sulcus and frontal
key motor
areas, such as the primary motor cortex, the
ventral premotor cortex, and the supplementary motor area.
Results—Compared
with healthy controls of similar age and sex, we observed significantly
enhanced reciprocal facilitatory connectivity
between the primary motor cortex and the
anterior intraparietal sulcus of the ipsilesional hemisphere. Beyond
that and as
a fingerprint of excellent recovery, the
coupling pattern of the parietofrontal network was near-normal. An
association between
coupling parameters and clinical scores was
not detected.
Conclusions—The
present analysis further adds to the understanding of the parietofrontal
network of the ipsilesional hemisphere as a prominent
circuit involved in plastic changes after
stroke.
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