Affiliations: Department of Neurology, Heinrich-Heine-University
Düsseldorf, Moorenstraße 5, D-40225 Düsseldorf, Germany | Present address: Department of Neurology,
Johann-Wolfgang-Goethe-University Frankfurt, D-60528, Frankfurt, Germany | Insitute of Medicine, Research Center Jülich, D-54525
Jülich, Germany
Abstract: Recovery of finger movements after hemiparetic stroke has been shown
to involve sensorimotor brain areas in perilesional and remote locations. Hand
use, however, critically depends on visual guidance in such patients with
stroke lesions in the middle cerebral artery territory. Using regional cerebral
blood flow measurements, we wished to identify interrelated brain areas that
are engaged in relation to manual activity in seven patients after their first
hemiparetic brain infarction. During the blind-folded performance of sequential
finger movements, the patients differed significantly from healthy controls (n
= 7) by the recruitment of a predominantly contralesional network involving
visual cortical areas, prefrontal cortex, thalamus, hippocampus, and
cerebellum. Greater expression of this cortical-subcortical network correlated
with a more severe sensorimotor deficit in the acute stage after stroke
reflecting its role for post-stroke recovery. Patients also differed from
controls on a lesion-related pattern expressed during rest. A third
differentiating pattern involved the ipsilesional supplementary motor area and
the contralesional premotor cortex. Our results suggest that post-stroke
recovery form impaired sensorimotor integration utilizes crossmodal plasticity
of a visual network.
Keywords: stroke, hemiparesis, sensorimotor integration, motor recovery, plasticity, functional imaging
