Comparative Functional MRI Study to Assess Brain Activation Upon Active and Passive Finger Movements in Patients with Cerebral Infarction

Fu, Yanwei; Zhang, Quan; Zhang, Jing; Zhang, Yun Ting

doi:10.1159/000366099

Cited by 6 publications

(4 citation statements)

References 20 publications

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“…The current study demonstrates that a passive movement task offers advantages in terms of objectivity, reproducibility and feasibility, compared to voluntary movement tasks, in studying recovery in patients with moderate to severe stroke (Loubinoux et al, 2001) (Fu et al, 2015, Tombari et al, 2004). Passive movement task-related brain activity measured across the sensorimotor network may provide a set of sensitive and specific biomarkers for assessing and predicting post-stroke motor recovery.…”

Section: Resultsmentioning

confidence: 87%

Parietal operculum and motor cortex activities predict motor recovery in moderate to severe stroke

Hannanu

Zeffiro

Lamalle³

et al. 2017

NeuroImage: Clinical

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While motor recovery following mild stroke has been extensively studied with neuroimaging, mechanisms of recovery after moderate to severe strokes of the types that are often the focus for novel restorative therapies remain obscure. We used fMRI to: 1) characterize reorganization occurring after moderate to severe subacute stroke, 2) identify brain regions associated with motor recovery and 3) to test whether brain activity associated with passive movement measured in the subacute period could predict motor outcome six months later.Because many patients with large strokes involving sensorimotor regions cannot engage in voluntary movement, we used passive flexion-extension of the paretic wrist to compare 21 patients with subacute ischemic stroke to 24 healthy controls one month after stroke. Clinical motor outcome was assessed with Fugl-Meyer motor scores (motor-FMS) six months later. Multiple regression, with predictors including baseline (one-month) motor-FMS and sensorimotor network regional activity (ROI) measures, was used to determine optimal variable selection for motor outcome prediction. Sensorimotor network ROIs were derived from a meta-analysis of arm voluntary movement tasks. Bootstrapping with 1000 replications was used for internal model validation.During passive movement, both control and patient groups exhibited activity increases in multiple bilateral sensorimotor network regions, including the primary motor (MI), premotor and supplementary motor areas (SMA), cerebellar cortex, putamen, thalamus, insula, Brodmann area (BA) 44 and parietal operculum (OP1-OP4). Compared to controls, patients showed: 1) lower task-related activity in ipsilesional MI, SMA and contralesional cerebellum (lobules V-VI) and 2) higher activity in contralesional MI, superior temporal gyrus and OP1-OP4. Using multiple regression, we found that the combination of baseline motor-FMS, activity in ipsilesional MI (BA4a), putamen and ipsilesional OP1 predicted motor outcome measured 6 months later (adjusted-R2 = 0.85; bootstrap p < 0.001). Baseline motor-FMS alone predicted only 54% of the variance. When baseline motor-FMS was removed, the combination of increased activity in ipsilesional MI-BA4a, ipsilesional thalamus, contralesional mid-cingulum, contralesional OP4 and decreased activity in ipsilesional OP1, predicted better motor outcome (djusted-R2 = 0.96; bootstrap p < 0.001).In subacute stroke, fMRI brain activity related to passive movement measured in a sensorimotor network defined by activity during voluntary movement predicted motor recovery better than baseline motor-FMS alone. Furthermore, fMRI sensorimotor network activity measures considered alone allowed excellent clinical recovery prediction and may provide reliable biomarkers for assessing new therapies in clinical trial contexts. Our findings suggest that neural reorganization related to motor recovery from moderate to severe stroke results from balanced changes in ipsilesional MI (BA4a) and a set of phylogenetically more archaic sensorimotor regions in the vent...

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Section: Resultsmentioning

confidence: 87%

Parietal operculum and motor cortex activities predict motor recovery in moderate to severe stroke

Hannanu

Zeffiro

Lamalle³

et al. 2017

NeuroImage: Clinical

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“…More than 75% of patients with cerebral infarction have motor impairment. Approximately 10% of all patients with cerebral infarction end up with a disability due to severe motor impairment [ 1 ]. Basal ganglia have neuronal connections with the cerebral cortex, thalamus, brainstem, and several other areas of the brain.…”

Section: Introductionmentioning

confidence: 99%

Longitudinal Assessment of Motor Recovery of Contralateral Hand after Basal Ganglia Infarction Using Functional Magnetic Resonance Imaging

Zhang

et al. 2016

BioMed Research International

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We used functional fMRI to study the brain activation during active finger movements at different time points during the recovery phase following basal ganglia infarction. Four hemiplegic patients with basal ganglia infarction were serially evaluated at different time points spanning the acute and chronic phase using fMRI. To evaluate motor recovery, the patients were asked to perform functional tasks arranged in a block design manner with their hand. On follow-up (chronic phase), three patients achieved significant recovery of motor function of affected limbs. Activation of bilateral sensorimotor cortex (SMC) was observed in two of these patients, while activation of cerebellum was observed in all patients. No remarkable recovery of motor function was noted in one patient with left basal ganglia infarction. In this patient, the activation domain was located in SMC of both sides in acute phase and in ipsilateral SMC in chronic phase. Contralateral SMC appears to be involved in the functional rehabilitation following basal ganglia infarction. The cerebellum may act as an intermediary during functional recovery following basal ganglia infarction. The activation domain associated with active finger movement may be bilateral in acute phase; one patient was ipsilateral in the chronic stage.

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“…Moreover, those who had greater brain activity patterns notably in the affected hemisphere responded better to the therapy. FMRI study by Fu et al on twenty-four stroke patients also discovered the increased activity of the bilateral premotor area and the bilateral supplementary motor area in stroke patients during active movement of the fingers [29].…”

Section: Discussionmentioning

confidence: 87%

The Role of Baseline Functional MRI as a Predictor of Post-Stroke Rehabilitation Efficacy in Patients with Moderate to Severe Upper Extremity Dysfunction

Ghaleh¹,

Rahimibarghani²,

Shirzad³

et al. 2022

JBBS

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Introduction: Upper extremity impairment is one of the common complications following a stroke. There are numerous rehabilitation strategies to address this problem. However, patients with moderate to severe upper limb disabilities respond differently to the same rehabilitation protocol. Apart from each patient's unique characteristics, there are specific brain reorganizing patterns that affect the post-rehabilitation response rate. Functional magnetic resonance imaging (fMRI) determines brain activation area and connectivity patterns and has been utilized in the neurorehabilitation field. Material and Methods: Six stroke patients who suffered from moderate to severe upper extremity dysfunction were enrolled in this pilot study. Upper extremity function tests including the Fugl-Meyer assessment test for upper extremity (FMA-UE), and Wolf Motor Function Test (WMFT) were utilized before and after completing an intensive rehabilitation. The intensive rehabilitation program was conducted one hour a day for five days per week for four weeks. Moreover, fMRI was applied before initiating rehabilitation. The regions of interest were those associated with movement, including Brodmann areas (BA) BA1-BA6. Results: Six stroke patients in the sub-acute to chronic phase and ages ranging between 33 -75 years were enrolled. All patients showed an improvement in upper limb function after four weeks of rehabilitation.

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Comparative Functional MRI Study to Assess Brain Activation Upon Active and Passive Finger Movements in Patients with Cerebral Infarction

Cited by 6 publications

References 20 publications

Parietal operculum and motor cortex activities predict motor recovery in moderate to severe stroke

Parietal operculum and motor cortex activities predict motor recovery in moderate to severe stroke

Longitudinal Assessment of Motor Recovery of Contralateral Hand after Basal Ganglia Infarction Using Functional Magnetic Resonance Imaging

The Role of Baseline Functional MRI as a Predictor of Post-Stroke Rehabilitation Efficacy in Patients with Moderate to Severe Upper Extremity Dysfunction

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