New brain networks are active after right MCA stroke when moving the ipsilesional arm.

OBJECTIVE: To determine whether, like the paretic arm, movement of the ipsilesional arm after middle cerebral artery (MCA) stroke is associated with widespread neural activation changes in areas anatomically and functionally connected to the lesion. METHODS: In this fMRI experiment, seven patients w...

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Published in:Neurology Vol. 64; no. 1; pp. 114 - 121
Main Authors: Hanlon CA, Buffington ALH, McKeown MJ
Format: research tables/charts Journal Article
Published: Lippincott Williams & Wilkins 2005 Jan 11
Online Access:View this record in EBSCOhost
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      dt: 2005 Jan 11
      vid: 64
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      pub: Lippincott Williams & Wilkins
      place: Baltimore, Maryland
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        106403614
        106403614
        2009113253
        10.1212/01.wnl.0000148726.45458.a9
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        106403614
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        atl: New brain networks are active after right MCA stroke when moving the ipsilesional arm.
      aug:
        au:
          Hanlon CA
          Buffington ALH
          McKeown MJ
        affil: Department of Neurobiology, Duke University, Durham, NC
      sug:
        subj:
          Arm Physiopathology
          Cerebral Arteries Physiopathology
          Stroke Complications
          Hemiplegia Physiopathology
          Aged
          British Columbia
          Case Control Studies
          Stroke Prognosis
          Stroke Psychosocial Factors
          Data Analysis, Statistical
          Descriptive Statistics
          Female
          Magnetic Resonance Imaging
          Male
          Middle Age
          Funding Source
          Human
          Aged: 65+ years
          Middle Aged: 45-64 years
          Female
          Male
      ab: OBJECTIVE: To determine whether, like the paretic arm, movement of the ipsilesional arm after middle cerebral artery (MCA) stroke is associated with widespread neural activation changes in areas anatomically and functionally connected to the lesion. METHODS: In this fMRI experiment, seven patients with right MCA stroke and seven healthy control subjects performed a series of movements with their (nonparetic) right hand. Subjects either mimicked a visual display (visually guided) or generated the same motor task after a visual start signal (self-monitored). A multivariate linear discriminant analysis was used to determine the combinations of brain regions of interest (ROIs) that demonstrated maximum differences in activation between healthy and stroke subjects. The analysis was repeated within subject groups to differentiate self-monitored and visually guided movement. RESULTS: There was a significantly different network of neural regions recruited for movement with the nonparetic, ipsilesional arm in patients with stroke vs healthy control subjects. The anterior cingulate cortex was significantly more active when patients execute self-monitored movement than visually guided movement, suggesting changes in attentional processing required for the two tasks. The lesioned hemisphere was significantly more active in patients with stroke using the nonparetic arm than in control subjects during visually guided movement. CONCLUSIONS: These results support a model of widespread bihemispheric reorganization in the motor system after a focal right hemisphere lesion. Attentional demands of self-monitored movement may be much greater than visually guided movement in patients, possibly impacting rehabilitation protocols for these patients.
      pubtype: Academic Journal
      doctype:
        research
        tables/charts
        Journal Article
      ougenre: Article
    language: English
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