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Cited by 1,019Stroke Rehabilitation and RecoveryTranscranial Magnetic Stimulation StudiesNeurobiology of Language and Bilingualism

A functional MRI study of subjects recovered from hemiparetic stroke

Cramer, Steven C., Nelles, Gereon, Benson, Randall R., Kaplan, Jill D., Parker, Robert A., Kwong, Ken K., Kennedy, David N., Finklestein, Seth P. +1 more·1997·Stroke
DOI 10.1161/01.str.28.12.2518
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Abstract

Background and Purpose Stroke recovery mechanisms remain incompletely understood, particularly for subjects with cortical stroke, in whom limited data are available. We used functional magnetic resonance imaging to compare brain activations in normal controls and subjects who recovered from hemiparetic stroke. Methods Functional magnetic resonance imaging was performed in ten stroke subjects with good recovery, five with deep, and five with cortical infarcts. Brain activation was achieved by index finger-tapping. Statistical parametric activation maps were obtained using a t test and a threshold of P <.001. In five bilateral motor regions, the volume of activated brain for each stroke subject was compared with the distribution of activation volumes among nine controls. Results Control subjects activated several motor regions. During recovered hand finger-tapping, stroke subjects activated the same regions as controls, often in a larger brain volume. In the unaffected hemisphere, sensorimotor cortex activation was increased in six of nine stroke subjects compared with controls. Cerebellar hemisphere contralateral and premotor cortex ipsilateral to this region, as well as supplementary motor areas, also had increased activation. In the stroke hemisphere, activation exceeding controls was uncommon, except that three of five cortical strokes showed peri-infarct activation foci. During unaffected hand finger-tapping, increased activation by stroke subjects compared with controls was uncommon; however, decreased activation was seen in unaffected sensorimotor cortex, suggesting that this region’s responsiveness increased to the ipsilateral hand and decreased to contralateral hand movements. Use of a different threshold for defining activation ( P <.01) did not change the overall findings (κ=.75). Conclusions Recovered finger-tapping by stroke subjects activated the same motor regions as controls but to a larger extent, particularly in the unaffected hemisphere. Increased reliance on these motor areas may represent an important component of motor recovery. Functional magnetic resonance imaging studies of subjects who recovered from stroke provide evidence for several processes that may be related to restoration of neurologic function.

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Authors
Cramer, S. C., Nelles, G., Benson, R. R., Kaplan, J. D., Parker, R. A., Kwong, K. K., Kennedy, D. N., Finklestein, S. P., & Rosen, B. R.
Affiliations
  • Beth Israel Deaconess Medical Center (US)
  • From the Department of Neurology, Massachusetts General Hospital, Harvard Medical School, Boston, Mass (S.C.C., G.N., J.D.K., D.N.K., S.P.F.); The Neurorecovery Program, Massachusetts General Hospital and Spaulding Rehabilitation Hospital, Harvard Medical School, Boston, Mass (S.C.C., G.N., J.D.K., S.A.F.); The Clinical Investigator Training Program, Harvard-MIT Division of Health Sciences and Technology and Beth Israel-Deaconess Medical Center in collaboration with Pfizer Inc. (S.C.C.); The MGH-NMR...
ORCID
Venue
Stroke
Publisher
Ovid Technologies (Wolters Kluwer Health)
Published
1997-12
Volume
28
Issue
12
Pages
2518-2527
ISSN
  • 0039-2499 (ISSN-L)
  • 1524-4628
DOI
10.1161/01.str.28.12.2518
OpenAlex
W2117597191
Cited by
1,019
References
69
Citations by year
2026: 12 · 2025: 23 · 2024: 23 · 2023: 18 · 2022: 41 · 2021: 24 · 2020: 25 · 2019: 39 · 2018: 24 · 2017: 32 · 2016: 26 · 2015: 31 · 2014: 35 · 2013: 37 · 2012: 39
FWCI
32.31
Type
journal article
Language
en
Open access
closed
Locations
  • Stroke (publishedVersion)
  • PubMed (publishedVersion)
Topics
  • Health Sciences › Medicine › Rehabilitation › Stroke Rehabilitation and Recovery
  • Life Sciences › Neuroscience › Neurology › Transcranial Magnetic Stimulation Studies
  • Life Sciences › Neuroscience › Cognitive Neuroscience › Neurobiology of Language and Bilingualism
Keywords
stroke recovery, hemiparesis, cortical infarction, sensorimotor cortex, finger tapping, motor cortex activation, premotor cortex, supplementary motor area, cerebellum, hemispheric lateralization
MeSH terms
Aged, Brain, Cerebral Infarction, Cerebrovascular Disorders, Female, Fingers, Hemiplegia, Humans, Magnetic Resonance Imaging, Male, Middle Aged, Motor Activity, Reference Values

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