I see nothing here that helps survivors recover. Useless.
Metabolic profile of motor cortex in stroke
Abstract
Background.
Although functional imaging and neurophysiological approaches reveal
alterations in motor and premotor areas after stroke, insights into
neurobiological events underlying these alterations are limited in human
studies.
Objective.
We tested whether cerebral metabolites
related to neuronal and glial compartments are altered in the hand
representation in bilateral motor and premotor areas and correlated with
distal and proximal arm motor impairment in hemiparetic persons.
Methods.
In 20 participants at >6 months postonset of a subcortical ischemic
stroke and 16 age- and sex-matched healthy controls, the concentrations
of N-acetylaspartate and myo-inositol were quantified by proton
magnetic resonance spectroscopy. Regions of interest identified by
functional magnetic resonance imaging included primary (M1), dorsal
premotor (PMd), and supplementary (SMA) motor areas. Relationships
between metabolite concentrations and distal (hand) and proximal
(shoulder/elbow) motor impairment using Fugl-Meyer Upper Extremity
(FMUE) subscores were explored.
Results.
N-Acetylaspartate was lower in M1 (P = .04) and SMA (P = .004) and myo-inositol was higher in M1 (P = .003) and PMd (P = .03) in the injured (ipsilesional) hemisphere after stroke compared with the left hemisphere in controls. N-Acetylaspartate in ipsilesional M1 was positively correlated with hand FMUE subscores (P = .04). Significant positive correlations were also found between N-acetylaspartate in ipsilesional M1, PMd, and SMA and in contralesional M1 and shoulder/elbow FMUE subscores (P = .02, .01, .02, and .02, respectively).
Conclusions.
Our preliminary results demonstrated that proton magnetic resonance
spectroscopy is a sensitive method to quantify relevant neuronal changes
in spared motor cortex after stroke and consequently increase our
knowledge of the factors leading from these changes to arm motor
impairment.
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