Assessing recovery in middle cerebral artery stroke using functional MRI

Nair, Dinesh; Fuchs, Armin; Burkart, Sandy L.; Steinberg, Fred; Kelso, J. A. Scott

doi:10.1080/02699050500149858

Cited by 17 publications

(11 citation statements)

References 64 publications

(87 reference statements)

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“…Therefore, if not properly addressed, these inter-subject variations in brain structures for normal individuals, children, older adults as well as the patient groups can result in imperfect compensations for brain region discrepancies after the spatial transformation (Argall et al, 2006;Hoeksma et al, 2005;Nair et al, 2005;Rademacher et al, 1993;Wilke et al, 2002). Moreover, the morphological differences between individuals in tested subjects and the brain template may lead to localization errors of the activation foci and/or result in decreased fMRI sensitivity in multi-subject studies Toga and Thompson, 2001).…”

Section: Introductionmentioning

confidence: 96%

Study-specific EPI template improves group analysis in functional MRI of young and older adults

Huang

Lee

Hsiao

et al. 2010

Journal of Neuroscience Methods

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Section: Introductionmentioning

confidence: 96%

Study-specific EPI template improves group analysis in functional MRI of young and older adults

Huang

Lee

Hsiao

et al. 2010

Journal of Neuroscience Methods

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“…15 The superior parietal lobule (BA 7) and the parietal precuneus are also involved in remembering and executing the correct order of task components and visuomotor function. 16,17 Moreover, the left superior temporal and bilateral inferior frontal gyri play a role in ideation of voluntary simple movement. 18 The right-left asymmetry in our findings might simply be an epiphenomenon reflecting differences in vascular embolic distribution between the right and left circulations in our relatively small cohort.…”

Section: Predicting Left Leg Motor Deficit Improvementmentioning

confidence: 99%

Location-weighted CTP analysis predicts early motor improvement in stroke

Payabvash¹,

Souza²,

Wang³

et al. 2012

Neurology

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Objective: To develop multivariate models for prediction of early motor deficit improvement in acute stroke patients with focal extremity paresis, using admission clinical and imaging data.Methods: Eighty consecutive patients with motor deficit due to first-ever unilateral stroke underwent CT perfusion (CTP) within 9 hours of symptom onset. Limb paresis was prospectively assessed using admission and discharge NIH Stroke Scale (NIHSS) scoring. CTP scans were coregistered to the MNI-152 brain space and subsegmented to 146 pairs of cortical/subcortical regions based on preset atlases. Stepwise multivariate binary logistic regressions were performed to determine independent clinical and imaging predictors of paresis improvement. Results:The rates of early motor deficit improvement were 18/49 (37%), 15/42 (36%), 8/25 (32%), and 7/23 (30%) for the right arm, right leg, left arm, and left leg, respectively. Admission NIHSS was the only independent clinical predictor of early limb motor deficit improvement. Relative CTP values of the inferior frontal lobe white matter, lower insular cortex, superior temporal gyrus, retrolenticular portion of internal capsule, postcentral gyrus, precuneus parietal gyri, putamen, and caudate nuclei were also independent predictors of motor improvement of different limbs. The multivariate predictive models of motor function improvement for each limb had 84%-92% accuracy, 79%-100% positive predictive value, 75%-94% negative predictive value, 83%-88% sensitivity, and 80%-100% specificity. Conclusions:We developed pilot multivariate models to predict early motor functional improvement in acute stroke patients using admission NIHSS and atlas-based location-weighted CTP data. These models serve as a "proof-of-concept" for prospective location-weighted imaging prediction of clinical outcome in acute stroke. Neurology ® 2012;78:1853-1859 GLOSSARY AUC ϭ area under the receiver operating characteristic curve; BA ϭ Brodmann area; CBF ϭ cerebral blood flow; CBV ϭ cerebral blood volume; CTA ϭ CT angiography; CTP ϭ CT perfusion; DWI ϭ diffusion-weighted imaging; GM ϭ gray matter; IA ϭ intra-arterial; ICA ϭ internal carotid artery; MCA ϭ middle cerebral artery; MRP ϭ magnetic resonance perfusion; MTT ϭ mean transit time; NIHSS ϭ NIH Stroke Scale; NPV ϭ negative predictive value; PPV ϭ positive predictive value; ROC ϭ receiver operating characteristic; tPA ϭ tissue plasminogen activator.One of the first questions asked by stroke patients and their families at admission is if and how soon they can expect improvement in their functional deficits. The ability to quantify the likelihood of such improvement could therefore be of great clinical interest.Important prognostic variables in current clinical practice include the admission NIH Stroke Scale (NIHSS) score and admission "core infarct" lesion volume on magnetic resonance diffusion-weighted imaging (DWI). However, admission infarct volume and clinical stroke severity alone can only predict 30% to 50% of the variance in motor impairment improvemen...

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“…Lotze et al were the first to demonstrate activation of the SMC with MI [39], and a large number of subsequent fMRI studies have confirmed this initial finding [22, 40]. MI of fingers, tongue, and toes activated a particular area of SMC, and only MI of fingers activated the SMC area representing fingers.…”

Section: Discussionmentioning

confidence: 97%

Mental Practice Combined with Physical Practice to Enhance Hand Recovery in Stroke Patients

Hua

Song

Zhang

2014

Behavioural Neurology

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Objectives. To evaluate whether combining mental practice with physical practice training enhances hand function in patients with stroke. Methods. 10 for treatment and 10 for control were recruited for this pre/posttraining matched case control study. In the treatment group, subjects underwent combining mental practice with physical practice for four weeks. In the control group, subjects only participated in physical practice. Change of hand function and the number of activated voxels of the contralateral somatosensory motor cortex (SMC) acquired by functional magnetic resonance imaging were measured. Results. After training, the Action Research Arm Test score increased by 12.65 for treatment and by 5.20 for control. There was a significant difference in the Action Research Arm Test score between the two groups (P = 0.04). The activated voxels number of the contralateral SMC increased in both groups, but the activated voxels number in the contralateral SMC and the improvement of hand function for treatment were greater than for control. In the treatment group, the number of activated voxels of the contralateral SMC was positively correlated with better hand function scores. Conclusions. Combining mental practice with physical practice may be a more effective treatment strategy than physical training alone for hand recovery in stroke patients.

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Assessing recovery in middle cerebral artery stroke using functional MRI

Cited by 17 publications

References 64 publications

Study-specific EPI template improves group analysis in functional MRI of young and older adults

Study-specific EPI template improves group analysis in functional MRI of young and older adults

Location-weighted CTP analysis predicts early motor improvement in stroke

Mental Practice Combined with Physical Practice to Enhance Hand Recovery in Stroke Patients

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