Cortical reorganization associated lower extremity motor recovery as evidenced by functional MRI and diffusion tensor tractography in a stroke patient

摘要: Purpose Recovery mechanisms supporting upper extremity motor recovery following stroke are well established, but cortical mechanism associated with lower is unknown. The aim of this study was to assess reorganization in a hemiparetic patient. Methods Six control subjects and 17 year-old woman left intracerebral hemorrhage due an arterio-venous malformation rupture were evaluated. function the paretic (left) hip knee had recovered slowly extent her being able overcome gravity for 10 months after onset stroke. However, showed no significant recovery. Blood oxygenation level dependent (BOLD) functional MRI at 1.5 Tesla used determine acutual location activation predefined regions interest. Concurrently, Diffusion Tensor Imaging (DTI) combination novel 3D-fiber reconstruction algorithm utilized investigate pattern corticospinal pathway connectivity between areas stream. All subjects' body parts secured scanner performed sequential flexion-extension predetermined angle 0-60 degrees 0.5 Hz. Results Controls anticipated contralateral sensorimotor cortex (SM1) descending fibers stemming from cortex. In contrast normal subjects, patient fMRI only unaffected (right) primary SM1 during either or nonparetic movements. DTT fiber tracing data that tract found hemisphere not affected hemisphere. Conclusions Our results indicate ipsilateral leg present This raises potential contralesional (ipsilateral) involved first neuroimaging evidence combined DTI can significantly expand explanatory power probing underlying