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Stroke. 2006 Jun;37(6):1552-5. Epub 2006 Apr 27.

Motor cortex activation during treatment may predict therapeutic gains in paretic hand function after stroke.

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  • 1Department of Biokinesiology and Physical Therapy, University of Southern California, Los Angeles, CA, USA.

Abstract

BACKGROUND AND PURPOSE:

Functional brain imaging after stroke offers insight into motor network adaptations. This exploratory study examined whether motor cortical activation captured during arm-focused therapy can predict paretic hand functional gains.

METHODS:

Eight hemiparetic patients had serial functional MRI (fMRI) while performing a pinch task before, midway, and after 2 weeks of constraint-induced therapy. The Wolf Motor Function Test (WMFT) was performed before and after intervention.

RESULTS:

There was a linear reduction in ipsilateral (contralesional) primary motor (M1) activation (voxel counts) across time. The midpoint M1 Laterality Index anticipated post-therapeutic change in time to perform the WMFT. The change in ipsilateral M1 voxel count (pre- to mid-) correlated with the change in mean WMFT time (pre- to post-).

CONCLUSIONS:

The relationship between brain activation during treatment and functional gains suggests a use for serial fMRI in predicting the success and optimal duration for a focused therapeutic intervention.

PMID:
16645139
[PubMed - indexed for MEDLINE]
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