Relationship between recovery of motor function and neuropsychological functioning in cerebral infarction patients: the importance of social functioning in motor recovery

We used functional fMRI to study the brain activation during active finger movements at different time points during the recovery phase following basal ganglia infarction. Four hemiplegic patients with basal ganglia infarction were serially evaluated at different time points spanning the acute and chronic phase using fMRI. To evaluate motor recovery, the patients were asked to perform functional tasks arranged in a block design manner with their hand. On follow-up (chronic phase), three patients achieved significant recovery of motor function of affected limbs. Activation of bilateral sensorimotor cortex (SMC) was observed in two of these patients, while activation of cerebellum was observed in all patients. No remarkable recovery of motor function was noted in one patient with left basal ganglia infarction. In this patient, the activation domain was located in SMC of both sides in acute phase and in ipsilateral SMC in chronic phase. Contralateral SMC appears to be involved in the functional rehabilitation following basal ganglia infarction. The cerebellum may act as an intermediary during functional recovery following basal ganglia infarction. The activation domain associated with active finger movement may be bilateral in acute phase; one patient was ipsilateral in the chronic stage.

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Forced, Not Voluntary, Aerobic Exercise Enhances Motor Recovery in Persons With Chronic Stroke

Neurorehabilitation and Neural Repair ◽

10.1177/1545968319862557 ◽

2019 ◽

Vol 33 (8) ◽

pp. 681-690 ◽

Cited By ~ 9

Author(s):

Susan M. Linder ◽

Anson B. Rosenfeldt ◽

Sara Davidson ◽

Nicole Zimmerman ◽

Amanda Penko ◽

...

Keyword(s):

Aerobic Exercise ◽

Motor Function ◽

Skill Acquisition ◽

Randomized Clinical Trials ◽

Motor Recovery ◽

Voluntary Exercise ◽

Fine Motor ◽

Significant Interaction Effect ◽

Task Practice ◽

Recovery Of Motor Function

Background. The recovery of motor function following stroke is largely dependent on motor learning–related neuroplasticity. It has been hypothesized that intensive aerobic exercise (AE) training as an antecedent to motor task practice may prime the central nervous system to optimize motor recovery poststroke. Objective. The objective of this study was to determine the differential effects of forced or voluntary AE combined with upper-extremity repetitive task practice (RTP) on the recovery of motor function in adults with stroke. Methods. A combined analysis of 2 preliminary randomized clinical trials was conducted in which participants (n = 40) were randomized into 1 of 3 groups: (1) forced exercise and RTP (FE+RTP), (2) voluntary exercise and RTP (VE+RTP), or (3) time-matched stroke-related education and RTP (Edu+RTP). Participants completed 24 training sessions over 8 weeks. Results. A significant interaction effect was found indicating that improvements in the Fugl-Meyer Assessment (FMA) were greatest for the FE+RTP group ( P = .001). All 3 groups improved significantly on the FMA by a mean of 11, 6, and 9 points for the FE+RTP, VE+RTP, and Edu+RTP groups, respectively. No evidence of a treatment-by-time interaction was observed for Wolf Motor Function Test outcomes; however, those in the FE+RTP group did exhibit significant improvement on the total, gross motor, and fine-motor performance times ( P ≤ .01 for all observations). Conclusions. Results indicate that FE administered prior to RTP enhanced motor skill acquisition greater than VE or stroke-related education. AE, FE in particular, should be considered as an effective antecedent to enhance motor recovery poststroke.

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Effects of Diabetes on Motor Recovery After Cerebral Infarct: A Diffusion Tensor Imaging Study

The Journal of Clinical Endocrinology & Metabolism ◽

10.1210/jc.2018-02502 ◽

2019 ◽

Vol 104 (9) ◽

pp. 3851-3858 ◽

Cited By ~ 4

Author(s):

Jun Sung Moon ◽

Seung Min Chung ◽

Sung Ho Jang ◽

Kyu Chang Won ◽

Min Cheol Chang

Keyword(s):

Motor Function ◽

Corticospinal Tract ◽

Diffusion Tensor ◽

Imaging Study ◽

Motor Recovery ◽

Cerebral Infarct ◽

Corona Radiata ◽

Patients With Diabetes ◽

Diffusion Tensor Imaging Study ◽

Recovery Of Motor Function

AbstractObjectiveLittle is known about the effects of diabetes on motor recovery after cerebral infarct. To address this question, we recruited patients with corona radiata infarct and controlled for the integrity of the corticospinal tract (CST) as determined by diffusion tensor tractography (DTT).DesignOne hundred patients were recruited, and DTT was performed within 7 to 30 days of infarct onset. Based on the DTT findings (DTT+, CST was preserved around the infarct; DTT−, CST was interrupted by the infarct) and the presence (DM+) or absence (DM−) of diabetes, patients were divided into DTT+/DM− (36 patients), DTT+/DM+ (19 patients), DTT−/DM− (32 patients), and DTT−/DM+ (13 patients) groups. Six months after cerebral infarct, motor function on the affected side was evaluated for each patient via the upper motricity index (MI), lower MI, modified Brunnstrom classification (MBC), and functional ambulation category (FAC).ResultsIn the patients with a DTT+ finding, no motor function scores were significantly different between the DTT+/DM− and DTT+/DM+ groups at 6-month evaluation. However, in patients with DTT− finding, all motor function scores at the 6-month evaluation were significantly higher in the DTT−/DM− group than in the DTT−/DM+ group.ConclusionWhen the CST is interrupted by a corona radiata infarct, recovery of motor function in patients with diabetes is more impaired than those without diabetes.

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