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

 Even stroke superstars like Julie Bernhardt don't produce research that gets survivors recovered(Creating protocols!). All because there is NO leadership in stroke directing researchers to solve stroke for survivor benefits!

• Prof Julie Bernhardt (10 posts to February 2018)

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

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.)