The relationship between motor deficit and primary motor cortex hemispheric activation balance after stroke: longitudinal fMRI study

Calautti, Cinzia; Jones, PS; Naccarato, Marcello; Sharma, Nikhil; Dj, Day; Bullmore, Edward T.; Warburton, E. Clea; Baron, J. H.

doi:10.1136/jnnp.2009.190512

Cited by 59 publications

(55 citation statements)

References 21 publications

(40 reference statements)

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“…Functional recovery after stroke has been observed and is currently attributed to both brain remodeling and plasticity (1)(2)(3)(4). Structural and functional remodeling of areas next to an infarct or remote regions can alter signaling within bilateral neuronal networks and thus contribute to functional recovery (3)(4)(5)(6)(7). Rewiring of neural connections is mediated by electrical activity, which can activate a number of plasticity mechanisms, including the release of activity-dependent neurotrophins such as brain-derived neurotrophic factor (BDNF) and nerve growth factor (NGF) (8)(9)(10).…”

mentioning

confidence: 99%

“…Brain stimulation is a promising area of research because it allows direct activation and manipulation of the target area's excitability (14)(15)(16). The primary motor cortex (M1) is a commonly stimulated area as it directly innervates the corticospinal tract to initiate movement (1,7). Although electrical stimulation and transcranial magnetic stimulation show promise in promoting recovery (17,18), these techniques are limited by imprecision and indiscriminate activation or inhibition of all cell types near the stimulated site; thus, they can produce undesired effects such as psychiatric and motor/speech problems (19)(20)(21).…”

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confidence: 99%

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Optogenetic neuronal stimulation promotes functional recovery after stroke

Cheng

Wang

Woodson

et al. 2014

Proc. Natl. Acad. Sci. U.S.A.

176

205

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Clinical and research efforts have focused on promoting functional recovery after stroke. Brain stimulation strategies are particularly promising because they allow direct manipulation of the target area's excitability. However, elucidating the cell type and mechanisms mediating recovery has been difficult because existing stimulation techniques nonspecifically target all cell types near the stimulated site. To circumvent these barriers, we used optogenetics to selectively activate neurons that express channelrhodopsin 2 and demonstrated that selective neuronal stimulations in the ipsilesional primary motor cortex (iM1) can promote functional recovery. Stroke mice that received repeated neuronal stimulations exhibited significant improvement in cerebral blood flow and the neurovascular coupling response, as well as increased expression of activity-dependent neurotrophins in the contralesional cortex, including brain-derived neurotrophic factor, nerve growth factor, and neurotrophin 3. Western analysis also indicated that stimulated mice exhibited a significant increase in the expression of a plasticity marker growth-associated protein 43. Moreover, iM1 neuronal stimulations promoted functional recovery, as stimulated stroke mice showed faster weight gain and performed significantly better in sensory-motor behavior tests. Interestingly, stimulations in normal nonstroke mice did not alter motor behavior or neurotrophin expression, suggesting that the prorecovery effect of selective neuronal stimulations is dependent on the poststroke environment. These results demonstrate that stimulation of neurons in the stroke hemisphere is sufficient to promote recovery. stroke recovery | channelrhodopsin

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mentioning

confidence: 99%

mentioning

confidence: 99%

Optogenetic neuronal stimulation promotes functional recovery after stroke

Cheng

Wang

Woodson

et al. 2014

Proc. Natl. Acad. Sci. U.S.A.

176

205

View full text Add to dashboard Cite

show abstract

“…An improvement in radio-uptake, and thus presumably perfusion, of 15% or greater was found in all patients at the time of the second scan. The volume of perihematomal brain in which this improvement was noted ranged from 7.2 to 71.3 cm 3 . This area was felt to represent at least part of the area of perihematomal hypoperfusion and suggests that aggressive measures to maintain perfusion and oxygenation to tissues could improve outcomes.…”

Section: Management and Monitoring Of Ichmentioning

confidence: 95%

“…The DEFUSE-EPITHET trial assessed 111 patients undergoing tPA for stroke using pretreatment DWI and PWI modalities. It was found that 89% of patients with a PWI-detected brain volume of 85 cm 3 with a "Tmax" (time until the theoretical maximal amount of residue function) greater than 8 seconds who achieved reperfusion had a modified Rankin Scale score of 5 or 6 at 90 days. Of these, only 67% were secondary to at least some level of parenchymal hemorrhage, which was also significantly more likely using the 85-cm 3 cutoff.…”

Section: Predicting Hemorrhage After Ischemic Eventsmentioning

confidence: 99%

“…One school of thought suggests that contralateral M1 activation is always dysfunctional and therapeutic strategies should be directed toward inhibiting it and restoring balance. 3,5 Another interpretation suggests that contralater al M1 activation is required for early recovery and becomes in hibitory/pathological at later time points. 33,34 These studies were supported by studies showing that contralateral transcranial magnetic stimulation improved motor performance on finger-tapping tests in control subjects 21 as well as on kinematic measures in chronically paretic (> 6 months) ischemic stroke patients.…”

Section: Understanding the Mechanisms Of Pathology And Recoverymentioning

confidence: 99%

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The role of advanced neuroimaging in intracerebral hemorrhage

McDowell

Kellner²,

Barton³

et al. 2013

FOC

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In this report, the authors sought to summarize existing literature to provide an overview of the currently available techniques and to critically assess the evidence for or against their application in intracerebral hemorrhage (ICH) for management, prognostication, and research. Functional imaging in ICH represents a potential major step forward in the ability of physicians to assess patients suffering from this devastating illness due to the advantages over standing imaging modalities focused on general tissue structure alone, but its use is highly controversial due to the relative paucity of literature and the lack of consolidation of the predominantly small data sets that are currently in existence. Current data support that diffusion tensor imaging and tractography, diffusion-perfusion weighted MRI techniques, and functional MRI all possess major potential in the areas of highlighting motor deficits, motor recovery, and network reorganization. Novel clinical studies designed to objectively assess the value of each of these modalities on a wider scale in conjunction with other methods of investigation and management will allow for their rapid incorporation into standard practice.

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Cortical reorganization after motor stroke: A pilot study on differences between the upper and lower limbs

Binder

Leimbach

Pool

et al. 2020

Human Brain Mapping

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Stroke patients suffering from hemiparesis may show substantial recovery in the first months poststroke due to neural reorganization. While reorganization driving improvement of upper hand motor function has been frequently investigated, much less is known about the changes underlying recovery of lower limb function. We, therefore, investigated neural network dynamics giving rise to movements of both the hands and feet in 12 well‐recovered left‐hemispheric chronic stroke patients and 12 healthy participants using a functional magnetic resonance imaging sparse sampling design and dynamic causal modeling (DCM). We found that the level of neural activity underlying movements of the affected right hand and foot positively correlated with residual motor impairment, in both ipsilesional and contralesional premotor as well as left primary motor (M1) regions. Furthermore, M1 representations of the affected limb showed significantly stronger increase in BOLD activity compared to healthy controls and compared to the respective other limb. DCM revealed reduced endogenous connectivity of M1 of both limbs in patients compared to controls. However, when testing for the specific effect of movement on interregional connectivity, interhemispheric inhibition of the contralesional M1 during movements of the affected hand was not detected in patients whereas no differences in condition‐dependent connectivity were found for foot movements compared to controls. In contrast, both groups featured positive interhemispheric M1 coupling, that is, facilitation of neural activity, mediating movements of the affected foot. These exploratory findings help to explain why functional recovery of the upper and lower limbs often develops differently after stroke, supporting limb‐specific rehabilitative strategies.

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The relationship between motor deficit and primary motor cortex hemispheric activation balance after stroke: longitudinal fMRI study

Cited by 59 publications

References 21 publications

Optogenetic neuronal stimulation promotes functional recovery after stroke

Optogenetic neuronal stimulation promotes functional recovery after stroke

The role of advanced neuroimaging in intracerebral hemorrhage

Cortical reorganization after motor stroke: A pilot study on differences between the upper and lower limbs

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