Affiliations: Department of Physical Medicine and Rehabilitation,
School of Medicine, Yeungnam University, Republic of Korea | Department of Rehabilitation Science, Taegu
University, Republic of Korea | Hampton University Phoenix Hall 219B, Hampton, VA
23668, USA
Note: [] Corresponding author: Department of Physical Medicine and
Rehabilitation, School of Medicine, Yeungnam University 317-1, Daemyungdong,
Namku, Taegu, 705-717, Republic of Korea. Tel.: +82 053 620 3269; Fax: +82 53
620 3269; E-mail: strokerehab@hanmail.net
Abstract: Purpose: Peri-lesional reorganization is a motor recovery mechanism
after brain injury. The object of this study was to demonstrate the
peri-lesional reorganization, using functional MRI (fMRI) and diffusion tensor
tractography (DTT). Methods: Six control subjects and a 53 year-old woman with left
primary sensori-motor cortex (SM1) and underlying deep white matter injury were
evaluated. The patient presented with complete paralysis of the right hand
after the resection of a meningioma on the left SM1. The motor function of the
affected hand had recovered slowly the extent of her being able to overcome
some resistance for 6 months. At 2 years after the operation, fMRI was
performed at 1.5 T in parallel with timed finger flexion-extension movements in
all subjects and DTT was performed only in the patient. Results: The contralateral SM1 centered on the precentral knob was
activated during hand movements of unaffected (left) side or control subjects.
However, the medial area of the injured SM1 was activated during affected
(right) hand movements. DTT of the affected (left) hemisphere originated from
the medial area of the injured SM1 and descended along the medial side of
injured deep white matter. Conclusions: It seems that the motor function of the affected hand
was reorganized into the medial area of the injured SM1 and deep white matter
in this patient.
