Motor and Premotor Cortices in Subcortical Stroke: Proton Magnetic Resonance Spectroscopy Measures and Arm Motor Impairment

 Absolutely NOTHING HERE WILL GET SURVIVORS RECOVERED! Stroke research, if any good at all, creates EXACT REHAB PROTOCOLS for recovery!

When you are the 1 in 4 per WHO that has a stroke, you just might want to recover! So maybe you want to do useful research NOW! Just a passing thought from a stroke addled brain! And look at all these Ph.D's not knowing that solving stroke is their job and they are completely fucking failing at it!

Oops, I'm not playing by the polite rules of Dale Carnegie,  'How to Win Friends and Influence People'. 

Telling supposedly smart stroke medical persons they know nothing about stroke is a no-no even if it is true. 

Politeness will never solve anything in stroke. Yes, I'm a bomb thrower and proud of it. Someday a stroke 'leader' will try to ream me out for making them look bad by being truthful, I look forward to that day.

Motor and Premotor Cortices in Subcortical Stroke: Proton Magnetic Resonance Spectroscopy Measures and Arm Motor Impairment

 
Motor and premotor cortices in subcortical stroke: protonmagnetic resonance spectroscopy measures and arm motorimpairment
Sorin C. Craciunas, MD, PhD
a,1
,
William M. Brooks, PhD
a,c
,
Randolph J. Nudo, PhD
b,d
,
Elena A. Popescu, PhD
a
,
In-Young Choi, PhD
a,c
,
Phil Lee, PhD
a,d
,
Hung-Wen Yeh, PhD
e
,
Cary R Savage, PhD
f
, and
Carmen M. Cirstea, MD, PhD
a,c,g,*
a
Hoglund Brain Imaging Center, University of Kansas Medical Center
b
Landon Center on Aging; Departments of, University of Kansas Medical Center
c
Neurology, University of Kansas Medical Center
d
Molecular and Integrative Physiology, University of Kansas Medical Center
e
Biostatistics, University of Kansas Medical Center
f
Psychiatry and Behavioral Sciences, University of Kansas Medical Center
g
Physical Therapy and Rehabilitation Science, University of Kansas Medical Center

Abstract

Background—
 

Although functional imaging and neurophysiological approaches revealalterations in motor and premotor areas after stroke, insights into neurobiological eventsunderlying these alterations are limited in human studies.
Objective—
 

We tested whether cerebral metabolites related to neuronal and glial compartmentsare altered in the hand representation in bilateral motor and premotor areas and correlated withdistal and proximal arm motor impairment in hemiparetic persons.
Methods—
 

In twenty participants at >6 months post-onset of a subcortical ischemic stroke andsixteen age and sex-matched healthy controls, the concentrations of N-acetylaspartate and myoinositol were quantified by proton magnetic resonance spectroscopy (1H-MRS). Regions of interest, identified by functional MRI, 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=0.04) and SMA (p=0.004) and myoinositol was higher in M1 (p=0.003) and PMd (p=0.03) in the injured (ipsilesional) hemisphere after stroke compared to the left hemisphere in controls. N-acetylaspartate in ipsilesional M1 was positively correlated with hand FMUE subscores (p=0.04). 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=0.02, 0.01, 0.02 and 0.02 respectively).
*
Corresponding author
 Hoglund Brain Imaging Center University of Kansas Medical Center 3901 Rainbow Blvd Mail Stop 1052Kansas City, Kansas US, 66160 Tel: (913) 588-4373 Fax: (913) 588-9071 .1
Present address
: Neurosurgery Department IV, Bagdasar-Arseni Hospital
NIH Public Access
Author Manuscript
 Neurorehabil Neural Repair
. Author manuscript; available in PMC 2014 June 01.