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Brain mapping of motor and functional recovery after supratentorial stroke

Choi, Eun Junga; Kyeong, Sunghyonc; Jeon, Hyun Mina; Kang, Hyunkoob; Kim, Dae Hyuna

doi: 10.1097/WNR.0000000000001100
CLINICAL NEUROSCIENCE
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SDC

Objective The present study aimed to identify the brain regions involved in upper and lower limb motor and functional recovery after stroke.

Methods Twenty-five patients (mean age 73.4 years; average duration from stroke onset 50.1 months) were examined. Fractional anisotropy (FA) mapping using diffusion tensor imaging, and clinical measures, including the Fugl–Meyer motor assessment of upper and lower limbs, the Modified Barthel Index (MBI), and Functional Ambulation Category, were used for examinations. Linear regression analyses were carried out with the FA map as a dependent variable, each clinical measure as an independent variable, and patient age as a covariate.

Results FA in the internal capsule of the posterior limb of the lesioned hemisphere was significantly associated with Fugl–Meyer motor assessment scores for the upper limbs, whereas FAs in the internal capsule of the posterior limb of the lesioned hemisphere, the posterior corpus callosum of the lesioned hemisphere, and the middle cerebellar peduncle of the contralateral hemisphere were associated with Fugl–Meyer motor assessment scores for the lower limb. FA in brain regions with bilateral connection fibers was commonly associated with the score on the Korean version of the MBI and participants’ functional ambulation. Furthermore, the FA in the corticospinal tract in the contralesional hemisphere was also associated with the score on the Korean version of the MBI (corrected P<0.05).

Conclusion Motor and functional recovery of upper and lower limbs involves different brain regions. This finding is of particular relevance for treatment and recovery in stroke.

Departments of aPhysical Medicine and Rehabilitation

bRadiology, Veterans Health Service Medical Center

cSeverance Biomedical Science Institute, Yonsei University College of Medicine, Seoul, South Korea

Correspondence to Dae Hyun Kim, MD, Department of Physical Medicine and Rehabilitation, Veterans Health Service Medical, Jinhwangdo-ro 61-gil, Seoul, Gangdong-gu, 05368 Seoul, South Korea Tel/fax: +82 222 254 177; e-mail: hohoho7490@gmail.com

Received June 7, 2018

Accepted June 23, 2018

© 2018 Wolters Kluwer Health | Lippincott Williams & Wilkins