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Motor and Premotor Cortices in Subcortical Stroke: Proton Magnetic Resonance Spectroscopy Measures and Arm Motor Impairment
Sorin C. Craciunas, MD, PhD ,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
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 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 twenty participants at >6 months post-onset of a subcortical ischemic stroke and sixteen 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), andsupplementary (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 myo-inositol 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.
Published in final edited form as:
Neurorehabil Neural Repair
. 2013 June ; 27(5): 411–420. doi:10.1177/1545968312469835.
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