Deans' stroke musings: Enhanced Effective Connectivity From Ipsilesional to Contralesional M1 in Well-Recovered Subcortical Stroke Patients

Changing stroke rehab and research worldwide now.Time is Brain! trillions and trillions of neurons that DIE each day because there are NO effective hyperacute therapies besides tPA(only 12% effective). I have 523 posts on hyperacute therapy, enough for researchers to spend decades proving them out. These are my personal ideas and blog on stroke rehabilitation and stroke research. Do not attempt any of these without checking with your medical provider. Unless you join me in agitating, when you need these therapies they won't be there.

What this blog is for:

My blog is not to help survivors recover, it is to have the 10 million yearly stroke survivors light fires underneath their doctors, stroke hospitals and stroke researchers to get stroke solved. 100% recovery. The stroke medical world is completely failing at that goal, they don't even have it as a goal. Shortly after getting out of the hospital and getting NO information on the process or protocols of stroke rehabilitation and recovery I started searching on the internet and found that no other survivor received useful information. This is an attempt to cover all stroke rehabilitation information that should be readily available to survivors so they can talk with informed knowledge to their medical staff. It lays out what needs to be done to get stroke survivors closer to 100% recovery. It's quite disgusting that this information is not available from every stroke association and doctors group.

Tuesday, August 27, 2019

Enhanced Effective Connectivity From Ipsilesional to Contralesional M1 in Well-Recovered Subcortical Stroke Patients

SO FUCKING WHAT?

You described a problem but offered NO SOLUTION. Useless.

Enhanced Effective Connectivity From Ipsilesional to Contralesional M1 in Well-Recovered Subcortical Stroke Patients

Yanmin Peng^1,2,

Jingchun Liu¹,

Minghui Hua^1,2,

Meng Liang^1,2^* and

Chunshui Yu^1,2^*

¹Department of Radiology and Tianjin Key Laboratory of Functional Imaging, Tianjin Medical University General Hospital, Tianjin, China
²School of Medical Imaging, Tianjin Medical University, Tianjin, China

Background and Purpose: Interhemispheric imbalance may provide a framework for developing new strategies to facilitate post-stroke motor recovery especially for patients in chronic stage. Using effective connectivity analysis, we aimed to investigate interactions between the bilateral primary motor cortices (M1) and their correlations with motor function and M1-related structural and functional changes in well-recovered patients with chronic subcortical ischemic stroke.

Methods: Twenty subcortical stroke patients and 20 normal controls underwent multimodal magnetic resonance imaging (MRI) examinations. During the movement of the affected hand, functional MRI was used to calculate the M1 activation and M1-M1 effective connectivity. Diffusion tensor imaging was used to compute the fractional anisotropy (FA) of the affected corticospinal tract (CST) and M1-M1 anatomical connection. After intergroup comparisons, we tested whether the altered M1-M1 effective connectivity was correlated with the motor function, M1 activation and FA of the affected CST and M1-M1 anatomical connection in patients.

Results: Compared to normal controls, stroke patients exhibited increased excitatory effective connectivity from ipsilesional to contralesional M1 and increased ipsilesional M1 activation; however, they showed reduced FA values in the affected CST and M1-M1 anatomical connection. The increased effective connectivity was positively correlated with motor score and the FA of the M1-M1 anatomical connection, but not with the M1 activation or the FA of the affected CST in these patients.

Conclusions: These findings suggest that the enhancement of M1-M1 effective connectivity from ipsilesional to contralesional hemisphere depends on the integrity of the underlying M1-M1 anatomical connection (i.e., less deficits of the M1-M1 anatomical connection, greater enhancement of the corresponding effective connectivity), and such M1-M1 effective connectivity enhancement plays a supportive role in motor function in chronic subcortical stroke.