Cortical activation changes in patients suffering from post-stroke arm spasticity and treated with botulinum toxin a.

摘要: BACKGROUND AND PURPOSE Botulinum toxin (BoNT) treatment relieves focal arm spasticity after stroke, likely acting at several hierarchical levels of the motor system. The central correlate BoNT-induced relief may be detected using repeated functional MRI (fMRI) during task. METHODS Five patients (4 males, 1 female, mean age 67 years) with hemiparesis and distal chronic ischemic stroke were studied. FMRI was performed while moving paretic hand in three sessions: before 4 11 weeks BoNT treatment. RESULTS Arm significantly decreased following across group (mean modified Ashworth scale change .6). prior to showed extensive bilateral active networks, whereas post-BoNT activation limited midline contralateral sensorimotor cortices, third examination, when effect has worn off, again similar pre-BoNT examination. Post-BoNT session 2 compared sessions 3 demonstrated a less frontoparietal areas including inferior frontal, postcentral, middle frontal gyri as well transient crossed cerebellar activation. CONCLUSION Relief post-stroke associated changes cortical system, prefrontal cortex.