Affiliations: Department of Physical Medicine and Rehabilitation,
School of Medicine, Yeungnam University, Republic of Korea | Department of Physical Medicine and Rehabilitation,
School of Medicine, Sungkyunkwan University, Samsung Medical Center, Republic
of Korea | Department of Diagnostic Radiology, College of
Medicine Kyungpook National University, South Korea | Department of Radiation Science, College of Health
Science, Yonsei University, Republic of Korea | Department of Diagnostic Radiology, School of
Medicine, Yeungnam University, Republic of Korea | Department of Neurosurgery, School of Medicine,
Yeungnam University, Republic of Korea
Note: [] Corresponding author: Sung Ho Jang, MD, 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 53 625 3508; E-mail: belado@med.yu.ac.kr
Abstract: Purpose: Contralateral primary sensori-motor cortex (SM1) activation
by passive movement was investigated by functional MRI (fMRI) at the early
stage of stroke, to determine whether SM1 activation can be used to predict the
degree of motor recovery of the hemiplegic hand. Methods: We studied 17 stroke patients who showed complete paralysis
of a hemiplegic hand at onset. The motor function of the hemiplegic hand was
assessed on 4 separate occasions (at onset, at fMRI evaluation (performed
< 4 weeks after onset), and 3 and 6 months after onset). Significant motor
recovery was defined as recovery of the affected hand to the extent of it being
able to prehend an object against gravity at least at 6 months after onset.
Results: The patients having an activated contralateral SM1 showed
better motor recovery than those who did not. Only a fourth of the patients
with an activated contralateral SM1 experienced a significant motor recovery,
whereas none of the patients with an inactivated SM1 showed an improvement 6
months after onset, however, the incidence of significant motor recovery was
not significantly difference between the two groups. Conclusions: It appears that contralateral SM1 activation by passive
movement in the early stage of stroke has a low predictive value for the motor
recovery of the hemiplegic hand, because the activation of the contralateral
SM1 by passive movement appears to be mediated by somatosensory input to the
cortex from the thalamus rather than from the motor pathway.
Keywords: functional magnetic resonance imaging, motor recovery, hemiplegia, stroke
