Brain activation of lower extremity movement in chronically impaired stroke survivors

Andreas R. Luft, Larry Forrester, Richard F. Macko, Sandy McCombe-Waller, Jill Whitall, Federico Villagra, Daniel F Hanley

Research output: Contribution to journalArticle

Abstract

Lower extremity paresis poses significant disability to chronic stroke survivors. Unlike for the upper extremity, cortical adaptations in networks controlling the paretic leg have not been characterized after stroke. Here, the hypotheses are that brain activation associated with unilateral knee movement in chronic stroke survivors is abnormal, depends on lesion location, and is related to walking ability. Functional magnetic resonance imaging of unilateral knee movement was obtained in 31 patients 26.9 months (mean, IQ range: 11.3-68.1) after stroke and in 10 age-matched healthy controls. Strokes were stratified according to lesion location. Locomotor disability (30 ft walking speed) did not differ between patient groups (9 cortical, 12 subcortical, 10 brainstem lesions). Significant differences in brain activation as measured by voxel counts in 10 regions of interest were found between controls and patients with brainstem (P = 0.006) and cortical strokes (P = 0.002), and between subcortical and cortical patients (P = 0.026). Statistical parametric mapping of data per group revealed similar activation patterns in subcortical patients and controls with recruitment of contralateral primary motor cortex (M1), supplementary motor area (SMA), and bilateral somatosensory area 2 (S2). Cortical recruitment was reduced in brainstem and cortical stroke. Better walking was associated with lesser contralateral sensorimotor cortex activation in brainstem, but stronger recruitment of ipsilateral sensorimotor and bilateral somatosensory cortices in subcortical and cortical patients, respectively. A post hoc comparison of brainstem patients with and without mirror movements (50%) revealed lesser recruitment of ipsilateral cerebellum in the latter. Subcortical patients with mirror movements (58%) showed lesser bilateral sensorimotor cortex activation. No cortical patient had mirror movements. The data reveal adaptations in networks controlling unilateral paretic knee movement in chronic stroke survivors. These adaptations depend on lesion location and seem to have functional relevance for locomotion.

Original languageEnglish (US)
Pages (from-to)184-194
Number of pages11
JournalNeuroImage
Volume26
Issue number1
DOIs
StatePublished - May 15 2005

Fingerprint

Survivors
Lower Extremity
Stroke
Brain
Brain Stem
Knee
Motor Cortex
Walking
Brain Stem Infarctions
Somatosensory Cortex
Paresis
Locomotion
Upper Extremity
Cerebellum
Leg
Magnetic Resonance Imaging

Keywords

  • Functional imaging
  • Hemiparesis
  • Locomotion
  • Lower extremity
  • Mirror movement
  • Stroke

ASJC Scopus subject areas

  • Cognitive Neuroscience
  • Neurology

Cite this

Luft, A. R., Forrester, L., Macko, R. F., McCombe-Waller, S., Whitall, J., Villagra, F., & Hanley, D. F. (2005). Brain activation of lower extremity movement in chronically impaired stroke survivors. NeuroImage, 26(1), 184-194. https://doi.org/10.1016/j.neuroimage.2005.01.027

Brain activation of lower extremity movement in chronically impaired stroke survivors. / Luft, Andreas R.; Forrester, Larry; Macko, Richard F.; McCombe-Waller, Sandy; Whitall, Jill; Villagra, Federico; Hanley, Daniel F.

In: NeuroImage, Vol. 26, No. 1, 15.05.2005, p. 184-194.

Research output: Contribution to journalArticle

Luft, AR, Forrester, L, Macko, RF, McCombe-Waller, S, Whitall, J, Villagra, F & Hanley, DF 2005, 'Brain activation of lower extremity movement in chronically impaired stroke survivors', NeuroImage, vol. 26, no. 1, pp. 184-194. https://doi.org/10.1016/j.neuroimage.2005.01.027
Luft AR, Forrester L, Macko RF, McCombe-Waller S, Whitall J, Villagra F et al. Brain activation of lower extremity movement in chronically impaired stroke survivors. NeuroImage. 2005 May 15;26(1):184-194. https://doi.org/10.1016/j.neuroimage.2005.01.027
Luft, Andreas R. ; Forrester, Larry ; Macko, Richard F. ; McCombe-Waller, Sandy ; Whitall, Jill ; Villagra, Federico ; Hanley, Daniel F. / Brain activation of lower extremity movement in chronically impaired stroke survivors. In: NeuroImage. 2005 ; Vol. 26, No. 1. pp. 184-194.
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