본문 바로가기
KERD
논문KCI 등재

Neural Correlates of Motor Recovery Measured by SPECT at Six Months After Basal Ganglia Stroke

1

조회

0

다운로드

0

인용

0

참고문헌

키워드

주제분류재활의학

초록

Objective To investigate neural correlates associated with recovery of motor function over 6 months in patients with basal ganglia (BG) stroke using acetazolamide (ACZ) stress brain-perfusion single-photon emission computed tomography (SPECT).Methods Medical records of 22 patients presenting first-ever BG stroke were retrospectively reviewed. Regional cerebral blood flow (CBF) and cerebrovascular reserve (CVR) were measured for 9 regions in each cerebral hemisphere (primary motor cortex, supplementary motor area, premotor cortex, prefrontal cortex, temporal lobe, parietal lobe, occipital lobe, BG, and thalamus). The Fugl-Meyer Assessment (FMA) motor score was used to assess motor function.Results After ACZ injection, CBF of all regions of interest (ROIs) increased compared with baseline. Baseline CBF of all ROIs was not significantly correlated with changes in FMA upper or lower motor score. However, multivariate analysis revealed CVR was significantly associated with change in FMA upper score in the ipsilateral primary motor cortex (R2=0.216, p=0.017), the ipsilateral parietal lobe (R2=0.135, p=0.029), and the contralateral primary motor cortex (R2=0.210, p=0.041).Conclusion CVR in the bilateral primary motor cortex and ipsilateral parietal lobe was associated with restoration of upper motor function 6 months after BG stroke. SPECT is a readily available imaging modality useful in studying brain residual function in patients with BG stroke.

Abstract

Objective To investigate neural correlates associated with recovery of motor function over 6 months in patients with basal ganglia (BG) stroke using acetazolamide (ACZ) stress brain-perfusion single-photon emission computed tomography (SPECT).Methods Medical records of 22 patients presenting first-ever BG stroke were retrospectively reviewed. Regional cerebral blood flow (CBF) and cerebrovascular reserve (CVR) were measured for 9 regions in each cerebral hemisphere (primary motor cortex, supplementary motor area, premotor cortex, prefrontal cortex, temporal lobe, parietal lobe, occipital lobe, BG, and thalamus). The Fugl-Meyer Assessment (FMA) motor score was used to assess motor function.Results After ACZ injection, CBF of all regions of interest (ROIs) increased compared with baseline. Baseline CBF of all ROIs was not significantly correlated with changes in FMA upper or lower motor score. However, multivariate analysis revealed CVR was significantly associated with change in FMA upper score in the ipsilateral primary motor cortex (R2=0.216, p=0.017), the ipsilateral parietal lobe (R2=0.135, p=0.029), and the contralateral primary motor cortex (R2=0.210, p=0.041).Conclusion CVR in the bilateral primary motor cortex and ipsilateral parietal lobe was associated with restoration of upper motor function 6 months after BG stroke. SPECT is a readily available imaging modality useful in studying brain residual function in patients with BG stroke.

참고문헌 (35)

  1. Stinear C, "Prediction of recovery of motor function after stroke", Lancet Neurol, 9, pp.1228~1232 (2010)
  2. Groenewegen HJ, "The basal ganglia and motor control", Neural Plast, 10, pp.107~120 (2003)
  3. Hikosaka O, "Central mechanisms of motor skill learning", Curr Opin Neurobiol, 12, pp.217~222 (2002)
  4. Grefkes C, "Connectivity-based approaches in stroke and recovery of function", Lancet Neurol, 13, pp.206~216 (2014)
  5. Carey LM, "Evolution of brain activation with good and poor motor recovery after stroke", Neurorehabil Neural Repair, 20, pp.24~41 (2006)
  6. Calautti C, "Dynamics of motor network overactivation after striatocapsular stroke: a longitudinal PET study using a fixed-performance paradigm", Stroke, 32, pp.2534~2542 (2001)
  7. Ward NS, "Motor system activation after subcortical stroke depends on corticospinal system integrity", Brain, 129(Pt 3), pp.809~819 (2006)
  8. Lindenberg R, "Structural integrity of corticospinal motor fibers predicts motor impairment in chronic stroke", Neurology, 74, pp.280~287 (2010)
  9. Vagal AS, "The acetazolamide challenge: techniques and applications in the evaluation of chronic cerebral ischemia", AJNR Am J Neuroradiol, 30, pp.876~884 (2009)
  10. Nuutinen J, "Perfusion differences on SPECT and PWI in patients with acute ischemic stroke", Neuroradiology, 51, pp.687~695 (2009)
  11. Kononen M, "Increased perfusion in motor areas after constraint-induced movement therapy in chronic stroke: a single-photon emission computerized tomography study", J Cereb Blood Flow Metab, 25, pp.1668~1674 (2005)
  12. Takekawa T, "Brain perfusion and upper limb motor function:a pilot study on the correlation between evolution of asymmetry in cerebral blood flow and improvement in Fugl-Meyer Assessment score after rTMS in chronic post-stroke patients", J Neuroradiol, 41, pp.177~183 (2014)
  13. Park SA, "The prediction of gross motor outcome using cerebrovascular reserve measured by acetazolamide-challenged SPECT", NeuroRehabilitation, 30, pp.359~367 (2012)
  14. Hattori N, "One-day protocol for cerebral perfusion reserve with acetazolamide", J Nucl Med, 37, pp.2057~2061 (1996)
  15. Haggard P, "Human volition: towards a neuroscience of will", Nat Rev Neurosci, 9, pp.934~946 (2008)
  16. Seitz RJ, "The role of diaschisis in stroke recovery", Stroke, 30, pp.1844~1850 (1999)
  17. Andaluz N, "Patient selection for revascularization procedures in adult Moyamoya disease based on dynamic perfusion computerized tomography with acetazolamide challenge (PCTA)", Neurosurg Rev, 33, pp.225~232 (2010)
  18. Iida H, "Multicenter evaluation of a standardized protocol for rest and acetazolamide cerebral blood flow assessment using a quantitative SPECT reconstruction program and split-dose 123Iiodoamphetamine", J Nucl Med, 51, pp.1624~1631 (2010)
  19. Yonas H, "CBF measured by Xe-CT: approach to analysis and normal values", J Cereb Blood Flow Metab, 11, pp.716~725 (1991)
  20. Kapucu OL, "EANM procedure guideline for brain perfusion SPECT using 99mTc-labelled radiopharmaceuticals, version 2", Eur J Nucl Med Mol Imaging, 36, pp.2093~2102 (2009)
  21. Cramer SC, "Predicting functional gains in a stroke trial", Stroke, 38, pp.2108~2114 (2007)
  22. Hultborn H, "Spinal control of locomotion:from cat to man", Acta Physiol (Oxf ), 189, pp.111~121 (2007)
  23. Luft AR, "Comparing brain activation associated with isolated upper and lower limb movement across corresponding joints", Hum Brain Mapp, 17, pp.131~140 (2002)
  24. Rehme AK, "Dynamic causal modeling of cortical activity from the acute to the chronic stage after stroke", Neuroimage, 55, pp.1147~1158 (2011)
  25. Favre I, "Upper limb recovery after stroke is associated with ipsilesional primary motor cortical activity:a meta-analysis", Stroke, 45, pp.1077~1083 (2014)
  26. Park CH, "Longitudinal changes of restingstate functional connectivity during motor recovery after stroke", Stroke, 42, pp.1357~1362 (2011)
  27. Rehme AK, "The role of the contralesional motor cortex for motor recovery in the early days after stroke assessed with longitudinal FMRI", Cereb Cortex, 21, pp.756~768 (2011)
  28. Nowak DA, "Effects of low-frequency repetitive transcranial magnetic stimulation of the contralesional primary motor cortex on movement kinematics and neural activity in subcortical stroke", Arch Neurol, 65, pp.741~747 (2008)
  29. Schulz R, "Enhanced effective connectivity between primary motor cortex and intraparietal sulcus in well-recovered stroke patients", Stroke, 47, pp.482~489 (2016)
  30. Schulz R, "Parietofrontal motor pathways and their association with motor function after stroke", Brain, 138(Pt 7), pp.1949~1960 (2015)
  31. O’Shea J, "Functional specificity of human premotor-motor cortical interactions during action selection", Eur J Neurosci, 26, pp.2085~2095 (2007)
  32. O’Shea J, "Functionally specific reorganization in human premotor cortex", Neuron, 54, pp.479~490 (2007)
  33. Park CH, "Predicting the performance of motor imagery in stroke patients: multivariate pattern analysis of functional MRI data", Neurorehabil Neural Repair, 29, pp.247~254 (2015)
  34. Gale SD, "Neuroimaging predictors of stroke outcome: implications for neurorehabilitation", NeuroRehabilitation, 31, pp.331~344 (2012)
  35. Latchaw RE, "Cerebral perfusion imaging in acute stroke", J Vasc Interv Radiol, 15(1 Pt 2), pp.S29~46 (2004)

관련 논문AI추천

Prediction of Motor Function Recovery after Subcortical Stroke: Case Series of Activation PET and TMS Studies김상은, 백남종, Se Hee Jung, Yu Kyeong Kim대한재활의학회 · Annals of Rehabilitation Medicine2012 · 제36권 제4호Crossed Cerebellar Diaschisis: Risk Factors and Correlation to Functional Recovery in Intracerebral Hemorrhage김명현, 김민수, 박순아, 신덕수, 주민철대한재활의학회 · Annals of Rehabilitation Medicine2018 · 제42권 제1호Resting-State Metabolism of Hand Knob Area on 18F-FDG PET-CT According to Hand Function and Tractography of Corticospinal Tract After Stroke김해원, 이동규대한재활의학회 · Annals of Rehabilitation Medicine2017 · 제41권 제2호Relationship Between Ipsilesional Upper Extremity Motor Function and Corpus Callosum Integrity in Patients With Unilateral Stroke: A Diffusion Tensor Imaging StudyKim Bo-Ram, Kim Hyuntae, Ko Nayeon, Kwon Bo Mi, Lee Hyun Haeng, Lee Jongmin, Lee Yejin, Moon Won-Jin대한뇌신경재활학회 · 뇌신경재활2022 · 제15권 제1호Dynamic Interactions Between Hemispheres Reveal a Compensatory Pathway for Motor Recovery in Moderate-to-Severe Subcortical StrokeBenjamin Becker, Craig S. Anderson, Hewei Wang, Huaxin Fan, Jianfeng Feng, Jie Zhang, Lili Song, Limin Sun, Mingxia Fan, Nanyu Kuang, Qiurong Yu, Xinran Wu, Zhengxu Lian대한뇌졸중학회 · 대한뇌졸중영문학회지2026 · 제28권 제1호Stroke Connectome and Its Implications for Cognitive and Behavioral Sequela of StrokeDong-Wha Kang, Jae-Sung Lim대한뇌졸중학회 · 대한뇌졸중영문학회지2015 · 제17권 제3호

이 간행물의 다른 논문 (23건)