This has nothing useful for stroke recovery. I'd fire everyone involved. Where the fuck is stroke leadership directing the strategy to solve stroke to 100% recovery?
Stroke Lesion Volume and Injury to Motor Cortex Output Determines Extent of Contralesional Motor Cortex Reorganization
Abstract
Background
After stroke, increases in contralesional primary motor cortex (M1CL) activity and excitability have been reported. In pre-clinical studies, M1CL reorganization is related to the extent of ipsilesional M1 (M1IL) injury, but this has yet to be tested clinically.
Objectives
We
tested the hypothesis that the extent of damage to the ipsilesional M1
and/or its corticospinal tract (CST) determines the magnitude of M1CL reorganization and its relationship to affected hand function in humans recovering from stroke.
Methods
Thirty-five
participants with a single subacute ischemic stroke affecting M1 or CST
and hand paresis underwent MRI scans of the brain to measure lesion
volume and CST lesion load. Transcranial magnetic stimulation (TMS) of
M1IL was used to determine the presence of an electromyographic response (motor evoked potential (MEP+ and MEP−)). M1CL reorganization was determined by TMS applied to M1CL at increasing intensities. Hand function was quantified with the Jebsen Taylor Hand Function Test.
Results
The extent of M1CL reorganization was related to greater lesion volume in the MEP− group, but not in the MEP+ group. Greater M1CL
reorganization was associated with more impaired hand function in MEP−
but not MEP+ participants. Absence of an MEP (MEP−), larger lesion
volumes and higher lesion loads in CST, particularly in CST fibers
originating in M1 were associated with greater impairment of hand
function.
Conclusions
In the subacute post-stroke period, stroke volume and M1IL output determine the extent of M1CL reorganization and its relationship to affected hand function, consistent with pre-clinical evidence.
ClinicalTrials.gov Identifier: NCT02544503
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