Title
The relationship between motor deficit and hemisphere activation balance after stroke: A 3T fMRI study.
Abstract
Functional imaging during movement of the hand affected by a stroke has shown excess activation of the contralesional motor network, implying less physiological hemisphere activation balance. Although this may be adaptive, the relationship between the severity of motor deficit and the hemisphere activation balance for the four major cortical motor areas has not been systematically studied. We prospectively studied 19 right-handed patients with first-ever stroke (age range 61±10 years) in the stable phase of recovery (>3 months after onset), using auditory-paced index–thumb (IT) tapping of the affected hand at 1.25 Hz as the fMRI paradigm. The hemisphere activation balance for the primary motor (M1), primary somatosensory (S1), supplementary motor (SMA) and dorsal premotor (PMd) areas was measured by a modified weighted laterality index (wLI), and correlations with motor performance (assessed by the affected/unaffected ratio of maximum IT taps in 15 s, termed IT-R) were computed. There were statistically significant negative correlations between IT-R and the wLI for M1 and S1, such that the more the hemispheric balance shifted contralesionally, the worse the performance. Furthermore, worse performance was related to a greater amount of contralesional, but not ipsilesional, activation. No significant correlation between IT-R and the wLI was obtained for the SMA and PMd, which functionally have stronger bilateral organization. These findings suggest that the degree of recovery of fine finger motion after stroke is determined by the extent to which activation balance in the primary sensory motor areas – where most corticospinal fibers originate – departs from normality. This observation may have implications for therapy.
Year
DOI
Venue
2007
10.1016/j.neuroimage.2006.08.026
NeuroImage
Keywords
Field
DocType
indexation,statistical significance,functional imaging,prospective study
SMA*,Developmental psychology,Laterality,Dorsum,Motor Deficit,Stroke,Psychology,Functional imaging,Correlation,Somatosensory system
Journal
Volume
Issue
ISSN
34
1
1053-8119
Citations 
PageRank 
References 
7
0.62
5
Authors
9
Name
Order
Citations
PageRank
Cinzia Calautti1163.24
Marcello Naccarato2111.40
P. S. Jones3585.28
Nikhil Sharma417924.87
Diana D. Day570.96
Adrian T. Carpenter670.96
Ed Bullmore71331150.94
Elizabeth A Warburton8131.77
Jean-Claude Baron9437.65