Affiliations: [a] Department of Nuclear Medicine, Institute of Wonkwang Medical Science, Wonkwang University College of Medicine and Hospital, Iksan, Korea | [b] Department of Physical Medicine and Rehabilitation, Institute of Wonkwang Medical Science, Regional Cardiocerebrovascular Center, Wonkwang University College of Medicine and Hospital, Iksan, Korea | [c] Sensory Motor Performance Program, Rehabilitation Institute of Chicago, Chicago, IL, USA | [d] Departments of Physical Medicine and Rehabilitation, Orthopaedic Surgery, and Biomedical Engineering, Northwestern University, Chicago, IL, USA
Correspondence:
[*]
Corresponding author: Chung-Yong Yang, MD, PhD, Department of PM&R, Wonkwang University College of Medicine, 344-2 Shinyong-dong, Iksan 570-749, South Korea, Sensory Motor Performance Program, Rehabilitation Institute of Chicago, and Northwestern University Feinberg School of Medicine, 345 E. Superior Street, Suite 1300A, Chicago, IL 60611, USA. Tel.: +1 312 238 1628; Fax: +1 312 238 2208; E-mail: rehab@wku.ac.kr; rehab@northwestern.edu
Abstract: The purpose of this study was to evaluate the relationship between the recovery of gross motor function and cerebrovascular reserve (CVR) capacity measured by brain perfusion single-photon emission computed tomography (SPECT) in patients with first-ever supratentorial infarction. Gross motor function was assessed according to the locomotor and mobility subset of the functional independence measure. The CVR was measured as the difference in the regional cerebral blood flow (rCBF) after acetazolamide (ACZ)-challenged 99mTc-ECD perfusion SPECT from baseline rCBF. All 22 hemiplegic patients (mean age, 60.97 years) enrolled were admitted at a mean of 20.86 days from onset and received rehabilitation care for an average of 38.82 days. The recovery of gross motor function was significantly correlated with baseline rCBF and CVR of ACZ-SPECT in the areas of affected supratentorial hemisphere (r = 0.447 and r = 0.444, respectively, p < 0.05). Analysis of the linear regression model, adjusted for time to SPECT testing, revealed that the CVR in the affected supratentorial hemisphere was a significant predictor of the gross motor outcome (p < 0.05). In conclusion, the CVR of the affected supratentorial hemisphere may be employed along with other parameters to predict the gross motor recovery of patients with subacute infarction.
Keywords: Stroke, prognosis, SPECT, cerebrovascular reserve, gross motor function
