Deans' stroke musings: Motor Impairment and Recovery in the Upper Limb After Stroke: Behavioral and Neuroanatomical Correlates

Changing stroke rehab and research worldwide now.Time is Brain! trillions and trillions of neurons that DIE each day because there are NO effective hyperacute therapies besides tPA(only 12% effective). I have 523 posts on hyperacute therapy, enough for researchers to spend decades proving them out. These are my personal ideas and blog on stroke rehabilitation and stroke research. Do not attempt any of these without checking with your medical provider. Unless you join me in agitating, when you need these therapies they won't be there.

What this blog is for:

My blog is not to help survivors recover, it is to have the 10 million yearly stroke survivors light fires underneath their doctors, stroke hospitals and stroke researchers to get stroke solved. 100% recovery. The stroke medical world is completely failing at that goal, they don't even have it as a goal. Shortly after getting out of the hospital and getting NO information on the process or protocols of stroke rehabilitation and recovery I started searching on the internet and found that no other survivor received useful information. This is an attempt to cover all stroke rehabilitation information that should be readily available to survivors so they can talk with informed knowledge to their medical staff. It lays out what needs to be done to get stroke survivors closer to 100% recovery. It's quite disgusting that this information is not available from every stroke association and doctors group.

Friday, May 31, 2024

Motor Impairment and Recovery in the Upper Limb After Stroke: Behavioral and Neuroanatomical Correlates

Even superstars like Julie Bernhardt don't create protocols from research to get stroke survivors recovered! Who then will actually create recovery protocols? SPECIFIC NAMES ONLY!

Motor Impairment and Recovery in the Upper Limb After Stroke: Behavioral and Neuroanatomical Correlates

2005, Stroke

Leeanne M. Carey, PhD; David F. Abbott, PhD; Gary F. Egan, PhD; Julie Bernhardt, PhD; Geoffrey A. Donnan, MD

Background and Purpose

Motor recovery after stroke is associated with cerebral reorganization. However, few studies have investigated the relationship directly, and findings are equivocal. We therefore aimed to characterize the relationship between motor impairment, motor recovery, and task-related changes in regional cerebral blood flow (△rCBF) longitudinally.

Methods

We obtained a profile of motor impairment and recovery in the upper limb and conducted positron emission tomography motor activation studies using a simple finger-tapping task in 9 stroke patients 2 to 7 weeks after stroke and 6 months later. For correlation analysis, mean images of task-related ⊿rCBF for each individual were linearly regressed with motor impairment scores. Motor recovery was correlated with longitudinal ⊿rCBF images.

Results—Patients

(7 males; 72.0±9.8 years) demonstrated a wide range of impairment severity and variable recovery. Upper-limb motor function was linearly correlated with task-related △rCBF. Importantly, sites of correlated ⊿rCBF differed over time. Subacutely correlated △rCBF was observed in supplementary motor area (SMA), bilateral cingulate, and contralesional insula with a small area in ipsilesional primary sensorimotor cortex (SM1). Conversely, at the 6-month study, correlated △rCBF was primarily in ipsilesional SM1, extending to the cingulate gyrus. Better motor recovery was correlated with reduction in contralesional activity and increase in ipsilesional SM1.

Conclusions

Upper-limb motor function and recovery are correlated with △rCBF in SMA, cingulate, insula, and SM1, highlighting the role of these areas in the recovery process. The dynamic nature of the relationship suggests ongoing adaptation within motor networks. (Stroke. 2005;36:625-629.)