Deans' stroke musings: Primary Motor Cortex in Stroke: A Functional MRI-Guided Proton MR Spectroscopic Study

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.

Tuesday, May 21, 2024

Primary Motor Cortex in Stroke: A Functional MRI-Guided Proton MR Spectroscopic Study

My conclusion is that NOTHING HERE WILL GET SURVIVORS RECOVERED! I'd fire all of you.

Primary Motor Cortex in Stroke: A Functional MRI-Guided Proton MR Spectroscopic Study

Carmen M. Cirstea, MD, PhD; William M. Brooks, PhD; Sorin C. Craciunas, MD; Elena A. Popescu, PhD; In-Young Choi, PhD; Phil Lee, PhD; Ali Bani-Ahmed, BSc; Hung-Wen Yeh, PhD; Cary R. Savage, PhD; Leonardo G. Cohen, MD; Randolph J. Nudo, PhD

Background and Purpose—

Our goal was to investigate whether certain metabolites, specific to neurons, glial cells, or the neuronal– glial neurotransmission system, in primary motor cortices (M1), are altered and correlated with clinical motor severity in chronic stroke.

Methods—

Fourteen survivors of a single ischemic stroke located outside the M1 and 14 age-matched healthy control subjects were included. At 6 months after stroke, N-acetylaspartate, myo-inositol, and glutamate/glutamine were measured using proton magnetic resonance spectroscopic imaging (in-plane resolution=5x5 mm 2 ) in radiologically normal-appearing gray matter of the hand representation area, identified by functional MRI, in each M1. Metabolite concentrations and analyses of metabolite correlations within M1 were determined. Relationships between metabolite concentrations and arm motor impairment were also evaluated.

Results—

The stroke survivors showed lower N-acetylaspartate and higher myo-inositol across ipsilesional and contralesional M1 compared with control subjects. Significant correlations between N-acetylaspartate and glutamate/glutamine were found in either M1. Ipsilesional N-acetylaspartate and glutamate/glutamine were positively correlated with arm motor impairment and contralesional N-acetylaspartate with time after stroke.

Conclusions—

Our preliminary data demonstrated significant alterations of neuronal glial interactions in spared M1 with the ipsilesional alterations related to stroke severity and contralesional alterations to stroke duration. Thus, MR spectroscopy might be a sensitive method to quantify relevant metabolite changes after stroke and consequently increase our knowledge of the factors leading from these changes in spared motor cortex to motor impairment after stroke. (Stroke. 2011;42:1004-1009.)