Early imaging correlates of subsequent motor recovery after stroke

Randolph S. Marshall, Eric Zarahn, Leeor Alon, Brandon Minzer, Ronald M. Lazar, John W. Krakauer

Research output: Contribution to journalArticle

Abstract

Objective: To determine whether functional magnetic resonance imaging activation obtained in the first few days after stroke correlates with subsequent motor recovery. Methods: Twenty-three patients with hemiparesis after first-time stroke were scanned at 2.0 ± 0.9 days while performing a simple motor task. We defined recovery as the change in Fugl-Meyer score from time of scan to approximately 3 months later (90 ± 8 days). We performed three different tests to assess correlations between brain activation and change in Fugl-Meyer score: (1) multivariate (most sensitive to spatially diffuse activation); (2) voxel-wise Statistical Parametric Mapping (most sensitive to focal activation), and (3) primary motor cortex region-of-interest analysis (most sensitive to average activation within this region). All tests controlled for initial stroke severity and lesion volume, as well as other established clinical variables. Results: The multivariate test was significant [F (595, 4,934) = 1.93; p < 0.001]. The Statistical Parametric Mapping test detected two small clusters of focal activity located in the ipsilesional postcentral gyrus and cingulate cortex (p < 0.05, corrected). The region-of-interest test was not significant. Interpretation: There is a pattern of brain activation present in the first few days after stroke, of which the postcentral gyrus and cingulate cortex are a part, that correlates with subsequent motor recovery. This result suggests that there are recovery processes engaged early after stroke that could provide a target for intervention.

Original languageEnglish (US)
Pages (from-to)596-602
Number of pages7
JournalAnnals of neurology
Volume65
Issue number5
DOIs
StatePublished - May 1 2009
Externally publishedYes

ASJC Scopus subject areas

  • Neurology
  • Clinical Neurology

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    Marshall, R. S., Zarahn, E., Alon, L., Minzer, B., Lazar, R. M., & Krakauer, J. W. (2009). Early imaging correlates of subsequent motor recovery after stroke. Annals of neurology, 65(5), 596-602. https://doi.org/10.1002/ana.21636