Relation of cerebral blood flow to motor and cognitive functions in chronic stroke patients.

Mori, Sakan; Sadoshima, Seizo; Ibayashi, Setsuro; Lino, Katia; Fujishima, Masatoshi

doi:10.1161/01.str.25.2.309

Cited by 27 publications

(19 citation statements)

References 67 publications

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“…In addition, we found that an increase in CBF correlated with reduction in locomotion during the light phase. These observations were consistent with those of previous studies, which showed that increased CBF is associated with improved neurological recovery [63][64][65]. However, the mechanism of angiogenesis-mediated functional recovery has remained unclear.…”

Section: Discussionsupporting

confidence: 93%

Bone Marrow Mononuclear Cells Promote Proliferation of Endogenous Neural Stem Cells Through Vascular Niches After Cerebral Infarction

et al. 2010

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Increasing evidence shows that administration of bone marrow mononuclear cells (BMMCs) is a potential treatment for various ischemic diseases, such as ischemic stroke. Although angiogenesis has been considered primarily responsible for the effect of BMMCs, their direct contribution to endothelial cells (ECs) by being a functional elements of vascular niches for neural stem/progenitor cells (NSPCs) has not been considered. Herein, we examine whether BMMCs affected the properties of ECs and NSPCs, and whether they promoted neurogenesis and functional recovery after stroke. We compared i.v. transplantations 1 3 10 6 BMMCs and phosphate-buffered saline in mice 2 days after cortical infarction. Systemically administered BMMCs preferentially accumulated at the postischemic cortex and periinfarct area in brains; cell proliferation of ECs (angiogenesis) at these regions was significantly increased in BMMCstreated mice compared with controls. We also found that endogenous NSPCs developed in close proximity to ECs in and around the poststroke cortex and that ECs were essential for proliferation of these ischemia-induced NSPCs. Furthermore, BMMCs enhanced proliferation of NSPCs as well as ECs. Proliferation of NSPCs was suppressed by additional treatment with endostatin (known to inhibit proliferation of ECs) following BMMCs transplantation. Subsequently, neurogenesis and functional recovery were also promoted in BMMCs-treated mice compared with controls. These results suggest that BMMCs can contribute to the proliferation of endogenous ischemia-induced NSPCs through vascular niche regulation, which includes regulation of endothelial proliferation. In addition, these results suggest that BMMCs transplantation has potential as a novel therapeutic option in stroke treatment.

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Section: Discussionsupporting

confidence: 93%

Bone Marrow Mononuclear Cells Promote Proliferation of Endogenous Neural Stem Cells Through Vascular Niches After Cerebral Infarction

et al. 2010

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Section: Discussionmentioning

confidence: 99%

“…It is possible that the widespread and lesionspecific metabolic changes after cerebral ischemia as observed in our patients were responsible for a residual deficit, as has been reported for patients with hemiparesis, neglect, and aphasia. [2][3][4]43,44 However, a consequential relationship between the observed widespread and remote changes in cerebral activity and functional recovery has not been demonstrated.In this study we show by means of a PCA that brain areas participating in a network related to recovery from brain infarction in the middle cerebral artery territory were also shared by another network that was affected by the stroke lesion. Specifically, the lesion-affected PC1 shared the same core areas as PC3 (Table 1).…”

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confidence: 99%

The Role of Diaschisis in Stroke Recovery

Seitz

Azari

Knorr

et al. 1999

Stroke

183

105

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Background and Purpose-Recovery from hemiparesis after stroke has been shown to involve reorganization in motor and premotor cortical areas. However, whether poststroke recovery also depends on changes in remote brain structures, ie, diaschisis, is as yet unresolved. To address this question, we studied regional cerebral blood flow in 7 patients (meanϮSD age, 54Ϯ8 years) after their first hemiparetic stroke. Methods-We analyzed imaging data voxel by voxel using a principal component analysis by which coherent changes in functional networks could be disclosed. Performance was assessed by a motor score and by the finger movement rate during the regional cerebral blood flow measurements. Results-The patients had recovered (PϽ0.001) from severe hemiparesis after on average 6 months and were able to perform sequential finger movements with the recovered hand. Regional cerebral blood flow at rest differentiated patients and controls (PϽ0.05) by a network that was affected by the stroke lesion. During blindfolded performance of sequential finger movements, patients were differentiated from controls (PϽ0.05) by a recovery-related network and a movement-control network. These networks were spatially incongruent, involving motor, sensory, and visual cortex of both cerebral hemispheres, the basal ganglia, thalamus, and cerebellum. The lesion-affected and recovery-related networks overlapped in the contralesional thalamus and extrastriate occipital cortex. Conclusions-Motor recovery after hemiparetic brain infarction is subserved by brain structures in locations remote from the stroke lesion. The topographic overlap of the lesion-affected and recovery-related networks suggests that diaschisis may play a critical role in stroke recovery. (Stroke. 1999;30:1844-1850.)Key Words: brain mapping Ⅲ hemiparesis Ⅲ infarction Ⅲ neuronal plasticity Ⅲ tomography, emission computed I n 1914, von Monakow 1 established the concept of diaschisis as a principle for recovery from brain lesions. Accordingly, functional changes in brain structures remote from the site of a focal brain damage, ie, diaschisis, were conceptualized as processes underlying functional recovery. The role of diaschisis, however, has remained elusive. Modern neuroimaging studies have provided first clues to the existence of diaschisis by revealing that focal brain lesions are accompanied by widespread metabolic changes involving the affected cerebral hemisphere but extending into brain areas supplied by contralateral and cerebellar arteries. 2 More recently, such remote metabolic changes have been shown to be lesionspecific in terms of cerebral topography and the related clinical deficits. 3,4 Corresponding findings in experimental models of ischemia further support the concept that these remote abnormalities are brought about acutely by neurotransmitter changes and chronically by degeneration of fiber tracts. 5 However, evidence that diaschisis is also related to recovery of function is virtually lacking.In this study we tested the hypothesis that lesion-induced, remot...

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“…Neuroimaging indicates that GVS increases blood flow [8], and electrical power spectra [9] in those temporalparietal and frontal regions of brain typically damaged in neglect. Such increases may be important for subsequent cognitive restoration and behavioural improvement [10]. At the psychological level, Karnath [11] has proposed that the central transformation that converts sensory input co-ordinates into an egocentric, bodycentered co-ordinate system is systematically skewed in neglect, resulting in a horizontal deviation of the spatial reference frame to the ipsilesional side.…”

Section: Introductionmentioning

confidence: 99%

The effect of repeated sessions of galvanic vestibular stimulation on target cancellation in visuo-spatial neglect: Preliminary evidence from two cases

et al. 2013

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Relation of cerebral blood flow to motor and cognitive functions in chronic stroke patients.

Cited by 27 publications

References 67 publications

Bone Marrow Mononuclear Cells Promote Proliferation of Endogenous Neural Stem Cells Through Vascular Niches After Cerebral Infarction

Bone Marrow Mononuclear Cells Promote Proliferation of Endogenous Neural Stem Cells Through Vascular Niches After Cerebral Infarction

The Role of Diaschisis in Stroke Recovery

The effect of repeated sessions of galvanic vestibular stimulation on target cancellation in visuo-spatial neglect: Preliminary evidence from two cases

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