Hell, 15 years later and I still have zero finger tapping ability. I obviously haven't evolved one bit in 15 years and likely will not evolve in the next 35 years either, so will be disabled for half my life thanks to my wonderful doctors who did absolutely nothing when all their previous patients did not recover.
Evolution of Brain Activation with Good and Poor Motor Recovery after Stroke
Leeanne M. Carey, PhD, David F. Abbott, PhD, Gary F. Egan, PhD,Graham J. O’Keefe, PhD, Graham D. Jackson, MD, Julie Bernhardt, PhD,and Geoffrey A. Donnan, MD
Objective
To characterize the evolution of brain activation in stroke patients with variable motor recovery and quantify changes relative to healthy controls.
Methods Serial PET activation studies, using a simple finger-tapping task, and quantitative measures of motor performance were obtained in 9 patients (2–7 weeks post stroke and 6 months later) and compared with serial healthy volunteer data. Results. Patients with moderate impairment and good recovery (n = 5) activated the primary sensorimotor cortex (SM1) contralateral to the paretic hand moved, bilateral supplementary motor area(SMA), contralateral cingulate gyrus, and ipsilateral lateral premotor cortex. Activation in the bilateral SMA was greater at the initial study but reduced over time com-pared to healthy controls and poor recoverers. Patients with severe impairment and poor recovery (n = 4)showed limited activation of contralateral SM1 and SMA at both studies and no significant change over time. A posterior shift in SM1 activation was evident in good and poor recoverers.
Conclusions.
Activation of typical motor regions and recruitment of additional sites occur subacutely post stroke, with evolution to normal patterns in moderately impaired patients who recover well. In comparison, severely impaired, poor-recovery patients show persistent, reduced activation. Dynamic changes in SMA, differentially observed in good recoverers over 6 months, highlight its importance in recovery.
Objective
To characterize the evolution of brain activation in stroke patients with variable motor recovery and quantify changes relative to healthy controls.
Methods Serial PET activation studies, using a simple finger-tapping task, and quantitative measures of motor performance were obtained in 9 patients (2–7 weeks post stroke and 6 months later) and compared with serial healthy volunteer data. Results. Patients with moderate impairment and good recovery (n = 5) activated the primary sensorimotor cortex (SM1) contralateral to the paretic hand moved, bilateral supplementary motor area(SMA), contralateral cingulate gyrus, and ipsilateral lateral premotor cortex. Activation in the bilateral SMA was greater at the initial study but reduced over time com-pared to healthy controls and poor recoverers. Patients with severe impairment and poor recovery (n = 4)showed limited activation of contralateral SM1 and SMA at both studies and no significant change over time. A posterior shift in SM1 activation was evident in good and poor recoverers.
Conclusions.
Activation of typical motor regions and recruitment of additional sites occur subacutely post stroke, with evolution to normal patterns in moderately impaired patients who recover well. In comparison, severely impaired, poor-recovery patients show persistent, reduced activation. Dynamic changes in SMA, differentially observed in good recoverers over 6 months, highlight its importance in recovery.
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