I see ABSOLUTELY NOTHING here that will help get survivors recovered! You're fired! A lot of Ph.Ds that know nothing about stroke recovery! Book learning means nothing; talk to survivors sometime.
Metabolic profile of motor cortex in stroke
Sorin C. Craciunas, MD, PhD
1
, William M. Brooks, PhD
1
,
Randolph J. Nudo, PhD
1
, Elena A. Popescu, PhD
1
, In-Young Choi, PhD
1
, Phil Lee, PhD
1
,
Hung-Wen Yeh, PhD
1
, Cary R. Savage, PhD
1
, and Carmen M. Cirstea, MD, PhD
1
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 post onset of a subcortical ischemic stroke and 16 age- and
sex-matched healthy controls, the concentrations of N-acetylaspartate and myoinositol 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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