A Functional MRI Study of Subjects Recovered From Hemiparetic Stroke

Cramer, Steven C.; Nelles, Gereon; Benson, Randall R.; Kaplan, Jill D.; Parker, Robert A.; Kwong, Kenneth K.; Kennedy, David N.; Finklestein, Seth P.; Rosen, Bruce R.

doi:10.1161/01.str.28.12.2518

Cited by 907 publications

(632 citation statements)

References 56 publications

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“…Results from neuroimaging studies in stroke patients support this theory, demonstrating increased recruitment of homotopic motor regions in the contralesional hemisphere by movement of an impaired hand. 30 Disruption of the uninjured hemisphere using transcranial magnetic stimulation has also been found to impair movement of the paretic (ipsilateral) hand. 31 The trend for increased FosB/DFosB expression in the contralesional forelimb motor cortex occurred predominantly in layer II/III, which has been shown to be sensitive to manipulation in forelimb use.…”

Section: Discussionmentioning

confidence: 99%

Early Poststroke Experience Differentially Alters Periinfarct Layer II and III Cortex

Clarke

Langdon

Corbett

2014

J Cereb Blood Flow Metab

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Early poststroke rehabilitation effectively improves recovery of function, likely by engaging multiple plasticity processes through use-dependent activation of neural circuits. The loci of such neuroplastic reorganization have not been examined during the initial phase of behavioral recovery. In the current study, we sought to evaluate sub-components of rehabilitation and to identify brain sites first engaged by early rehabilitation. Rats were subjected to endothelin-1 ischemia and placed in either enriched environment (EE), daily reach training (RT), combination of enriched environment and reach training (ER), or standard housing (ST) starting 7 days post ischemia. Functional and histopathological assessments were made after 2, 5, and 10 days of treatment. Animals exposed to 10 days of ER treatment exhibited significantly more use-dependent neuronal activity (FosB/DFosB expression) in perilesional cortex than those exposed to EE, RT, or ST treatments. Similar trends were observed in both perilesional striatum and contralesional forelimb motor cortex. This use-dependent plasticity was not explained by differences in neuronal death, inflammation, or lesion volume. The increased activity likely contributes to the neuroplastic changes and functional recovery observed after extended periods of rehabilitation. Importantly, EE or RT alone did not lead to enhanced activity suggesting that combination therapy is necessary to promote maximum recovery.

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Section: Discussionmentioning

confidence: 99%

Early Poststroke Experience Differentially Alters Periinfarct Layer II and III Cortex

Clarke

Langdon

Corbett

2014

J Cereb Blood Flow Metab

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“…In addition, there are a large number of parallel pathways for controlling manual dexterity in the CNS (Darian-Smith et al, 1999). After stroke, in the inhibitory CNS environment, there may be an advantage to use these available pathways for formation of new circuits via shortrange axonal sprouting from neighboring uninjured fibers rather than from long-distance outgrowth of injured fibers (Cramer et al, 1997).…”

Section: Discussionmentioning

confidence: 99%

Axonal sprouting into the denervated spinal cord and synaptic and postsynaptic protein expression in the spinal cord after transplantation of bone marrow stromal cell in stroke rats

Liu¹,

Li²,

Qu³

et al. 2007

Brain Research

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We investigated whether compensatory reinnervation in the corticospinal tract (CST) and the corticorubral tract (CRT) is enhanced by administration of bone marrow stromal cells (BMSCs) after experimental stroke. Adult male Wistar rats were subjected to permanent right middle cerebral artery occlusion (MCAo). Phosphate-buffered saline (PBS, control, n=7) or 3 × 10 6 BMSCs in PBS (n=8) were injected into a tail vein at 1 day postischemia. The CST of the left sensorimotor cortices was labeled with DiI 2 days prior to MCAo. Functional recovery was measured. Rats were sacrificed at 28 days after MCAo. The brain and spinal cord were removed and processed for vibratome sections for laser-scanning confocal analysis and paraffin sections for immunohistochemistry. Normal rats (n=4) exhibited a predominantly unilateral pattern of innervation of CST and CRT axons. After stroke, bilateral innervation occurred through axonal sprouting of the uninjured CRT and CST. Administration of BMSCs significantly increased the axonal restructuring on the de-afferented red nucleus and the denervated spinal motoneurons (p<0.05). BMSC treatment also significantly increased synaptic proteins in the denervated motoneurons. These results were highly correlated with improved functional outcome after stroke (r>0.81, p<0.01). We conclude that the transplantation of BMSCs enhance axonal sprouting and rewiring into the denervated spinal cord which may facilitate functional recovery after focal cerebral ischemia.

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“…An issue of particular interest is the role of the motor cortex ipsilateral to the affected hand when patients move this hand. Evidence for ipsilateral involvement, in addition to contralateral activation, has been reported in positron emission tomography (PET) [17,18] and functional MRI studies [19 -21], but with a focus of activity in the ipsilateral premotor cortex [18,19,22]. Although we did not perform functional imaging to document functional reorganization, 'cortical plasticity', i.e., right hemispheric control of right limb motor functions, could have played a role in the development of GAWH in our patients.…”

Section: Discussionmentioning

confidence: 99%

Global aphasia without hemiparesis: lesion analysis and its mechanism in 11 Korean patients

Bang

Heo

Kwak

et al. 2004

Journal of the Neurological Sciences

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A Functional MRI Study of Subjects Recovered From Hemiparetic Stroke

Cited by 907 publications

References 56 publications

Early Poststroke Experience Differentially Alters Periinfarct Layer II and III Cortex

Early Poststroke Experience Differentially Alters Periinfarct Layer II and III Cortex

Axonal sprouting into the denervated spinal cord and synaptic and postsynaptic protein expression in the spinal cord after transplantation of bone marrow stromal cell in stroke rats

Global aphasia without hemiparesis: lesion analysis and its mechanism in 11 Korean patients

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