A preliminary fMRI study on activiation pattern and functional reorganization of motor cortex in acute ischemic stroke patients

Objective To observe and explore the activation pattern and functional reorganization mechanism of motor cortex in acute ischemic stroke patients. Methods A total of 22 patients with first-ever acute ischemic stroke were included in this study. Functional magnetic resonance imaging (fMRI) was used...

Full description

Bibliographic Details
Main Authors: Fan-yong ZENG, Zhi-qiang ZHANG, Fang YANG, Jian-ping HU, Qiang XU, Guang-ming LU
Format: Article
Language:English
Published: Tianjin Huanhu Hospital 2017-12-01
Series:Chinese Journal of Contemporary Neurology and Neurosurgery
Subjects:
Online Access:http://www.cjcnn.org/index.php/cjcnn/article/view/1703
id doaj-e14a34050597472d81ac7ceaadb8ad6d
record_format Article
collection DOAJ
language English
format Article
sources DOAJ
author Fan-yong ZENG
Zhi-qiang ZHANG
Fang YANG
Jian-ping HU
Qiang XU
Guang-ming LU
spellingShingle Fan-yong ZENG
Zhi-qiang ZHANG
Fang YANG
Jian-ping HU
Qiang XU
Guang-ming LU
A preliminary fMRI study on activiation pattern and functional reorganization of motor cortex in acute ischemic stroke patients
Chinese Journal of Contemporary Neurology and Neurosurgery
Stroke
Brain ischemia
Motor cortex
Magnetic resonance imaging
author_facet Fan-yong ZENG
Zhi-qiang ZHANG
Fang YANG
Jian-ping HU
Qiang XU
Guang-ming LU
author_sort Fan-yong ZENG
title A preliminary fMRI study on activiation pattern and functional reorganization of motor cortex in acute ischemic stroke patients
title_short A preliminary fMRI study on activiation pattern and functional reorganization of motor cortex in acute ischemic stroke patients
title_full A preliminary fMRI study on activiation pattern and functional reorganization of motor cortex in acute ischemic stroke patients
title_fullStr A preliminary fMRI study on activiation pattern and functional reorganization of motor cortex in acute ischemic stroke patients
title_full_unstemmed A preliminary fMRI study on activiation pattern and functional reorganization of motor cortex in acute ischemic stroke patients
title_sort preliminary fmri study on activiation pattern and functional reorganization of motor cortex in acute ischemic stroke patients
publisher Tianjin Huanhu Hospital
series Chinese Journal of Contemporary Neurology and Neurosurgery
issn 1672-6731
publishDate 2017-12-01
description Objective To observe and explore the activation pattern and functional reorganization mechanism of motor cortex in acute ischemic stroke patients. Methods A total of 22 patients with first-ever acute ischemic stroke were included in this study. Functional magnetic resonance imaging (fMRI) was used to observe the changing of activation pattern and functional reorganization of motor cortex in finger-tapping task. National Institutes of Health Stroke Scale (NIHSS) and Fugl-Meyer Assessment Scale for Upper Extremity (FMA-UE) were used to evaluate motor function, and neuroelectrophysiology monitored resting motor threshold (RMT). Spearman rank correlation analysis was used to analyze the correlation between activation of region of interest (ROI) and neurological function, motor function and neuroelectrophysiology. Moreover, dynamic causal model (DCM) was used to analyze the intrahemispheric and interhemispheric effective connectivity between brain regions in finger-tapping task. Results Movements of the affected hand showed significant signal activation in the ipsilesional primary motor cortex (M1), premotor cortex (PMC) and bilateral supplementary motor area (SMA), while the contralesional PMC, posterior parietal cortex (PPC) and bilateral cerebellar hemisphere also showed slight activation. Movements of the unaffected hand showed significant activation in the contralesional M1, PMC and SMA, while the ipsilesional SMA and inferior parietal lobule also showed slight activation. The activation value of ipsilesional M1 was negatively correlated with neurological function (NIHSS score; rs = -0.452, P = 0.035) and positively correlated with motor function of upper extremity (FMA-UE score; rs = 0.543, P = 0.009). The activation value of ipsilesional sensorimotor cortex (SMC) was positively correlated with RMT (rs = 0.718, P = 0.001). The advantage model of DCM showed bidirectional suppressive influence of connectivity between bilateral M1, negative effective connectivity from contralesional SMA to M1, positive effective connectivity from contralesional SMA to ipsilesional M1 and from ipsilesional SMA to contralesional SMA. The intensity of effective connectivity from contralesional to ipsilesional M1 was negatively correlated with motor function (FMA-UE score; rs = -0.461, P = 0.047). The intensity of effective connectivity from contralesional SMA to contralesional M1 was positively correlated with motor function (FMA-UE score; rs = 0.533, P = 0.041). Conclusions fMRI combined with neurological function, motor function and electrophysiology can be used to observe activation pattern and functional reorganization mechanism of motor cortex in acute ischemic stroke patients, and provide new insights into understanding the motor impairment and functional reorganization after stroke and rehabilitation therapy. DOI: 10.3969/j.issn.1672-6731.2017.12.005
topic Stroke
Brain ischemia
Motor cortex
Magnetic resonance imaging
url http://www.cjcnn.org/index.php/cjcnn/article/view/1703
work_keys_str_mv AT fanyongzeng apreliminaryfmristudyonactiviationpatternandfunctionalreorganizationofmotorcortexinacuteischemicstrokepatients
AT zhiqiangzhang apreliminaryfmristudyonactiviationpatternandfunctionalreorganizationofmotorcortexinacuteischemicstrokepatients
AT fangyang apreliminaryfmristudyonactiviationpatternandfunctionalreorganizationofmotorcortexinacuteischemicstrokepatients
AT jianpinghu apreliminaryfmristudyonactiviationpatternandfunctionalreorganizationofmotorcortexinacuteischemicstrokepatients
AT qiangxu apreliminaryfmristudyonactiviationpatternandfunctionalreorganizationofmotorcortexinacuteischemicstrokepatients
AT guangminglu apreliminaryfmristudyonactiviationpatternandfunctionalreorganizationofmotorcortexinacuteischemicstrokepatients
AT fanyongzeng preliminaryfmristudyonactiviationpatternandfunctionalreorganizationofmotorcortexinacuteischemicstrokepatients
AT zhiqiangzhang preliminaryfmristudyonactiviationpatternandfunctionalreorganizationofmotorcortexinacuteischemicstrokepatients
AT fangyang preliminaryfmristudyonactiviationpatternandfunctionalreorganizationofmotorcortexinacuteischemicstrokepatients
AT jianpinghu preliminaryfmristudyonactiviationpatternandfunctionalreorganizationofmotorcortexinacuteischemicstrokepatients
AT qiangxu preliminaryfmristudyonactiviationpatternandfunctionalreorganizationofmotorcortexinacuteischemicstrokepatients
AT guangminglu preliminaryfmristudyonactiviationpatternandfunctionalreorganizationofmotorcortexinacuteischemicstrokepatients
_version_ 1725617217838514176
spelling doaj-e14a34050597472d81ac7ceaadb8ad6d2020-11-24T23:07:46ZengTianjin Huanhu HospitalChinese Journal of Contemporary Neurology and Neurosurgery1672-67312017-12-0117128838901663A preliminary fMRI study on activiation pattern and functional reorganization of motor cortex in acute ischemic stroke patientsFan-yong ZENG0Zhi-qiang ZHANG1Fang YANG2Jian-ping HU3Qiang XU4Guang-ming LU5Department of Medical Imaging, Jinling Hospital, Medical School of Nanjing University; Nanjing General Hospital of Nanjing Military Command of Chinese PLA, Nanjing 210002, Jiangsu, ChinaDepartment of Medical Imaging, Jinling Hospital, Medical School of Nanjing University; Nanjing General Hospital of Nanjing Military Command of Chinese PLA, Nanjing 210002, Jiangsu, ChinaDepartment of Neurology, Jinling Hospital, Medical School of Nanjing University; Nanjing General Hospital of Nanjing Military Command of Chinese PLA, Nanjing 210002, Jiangsu, ChinaDepartment of Medical Imaging, Jinling Hospital, Medical School of Nanjing University; Nanjing General Hospital of Nanjing Military Command of Chinese PLA, Nanjing 210002, Jiangsu, ChinaDepartment of Medical Imaging, Jinling Hospital, Medical School of Nanjing University; Nanjing General Hospital of Nanjing Military Command of Chinese PLA, Nanjing 210002, Jiangsu, ChinaDepartment of Medical Imaging, Jinling Hospital, Medical School of Nanjing University; Nanjing General Hospital of Nanjing Military Command of Chinese PLA, Nanjing 210002, Jiangsu, ChinaObjective To observe and explore the activation pattern and functional reorganization mechanism of motor cortex in acute ischemic stroke patients. Methods A total of 22 patients with first-ever acute ischemic stroke were included in this study. Functional magnetic resonance imaging (fMRI) was used to observe the changing of activation pattern and functional reorganization of motor cortex in finger-tapping task. National Institutes of Health Stroke Scale (NIHSS) and Fugl-Meyer Assessment Scale for Upper Extremity (FMA-UE) were used to evaluate motor function, and neuroelectrophysiology monitored resting motor threshold (RMT). Spearman rank correlation analysis was used to analyze the correlation between activation of region of interest (ROI) and neurological function, motor function and neuroelectrophysiology. Moreover, dynamic causal model (DCM) was used to analyze the intrahemispheric and interhemispheric effective connectivity between brain regions in finger-tapping task. Results Movements of the affected hand showed significant signal activation in the ipsilesional primary motor cortex (M1), premotor cortex (PMC) and bilateral supplementary motor area (SMA), while the contralesional PMC, posterior parietal cortex (PPC) and bilateral cerebellar hemisphere also showed slight activation. Movements of the unaffected hand showed significant activation in the contralesional M1, PMC and SMA, while the ipsilesional SMA and inferior parietal lobule also showed slight activation. The activation value of ipsilesional M1 was negatively correlated with neurological function (NIHSS score; rs = -0.452, P = 0.035) and positively correlated with motor function of upper extremity (FMA-UE score; rs = 0.543, P = 0.009). The activation value of ipsilesional sensorimotor cortex (SMC) was positively correlated with RMT (rs = 0.718, P = 0.001). The advantage model of DCM showed bidirectional suppressive influence of connectivity between bilateral M1, negative effective connectivity from contralesional SMA to M1, positive effective connectivity from contralesional SMA to ipsilesional M1 and from ipsilesional SMA to contralesional SMA. The intensity of effective connectivity from contralesional to ipsilesional M1 was negatively correlated with motor function (FMA-UE score; rs = -0.461, P = 0.047). The intensity of effective connectivity from contralesional SMA to contralesional M1 was positively correlated with motor function (FMA-UE score; rs = 0.533, P = 0.041). Conclusions fMRI combined with neurological function, motor function and electrophysiology can be used to observe activation pattern and functional reorganization mechanism of motor cortex in acute ischemic stroke patients, and provide new insights into understanding the motor impairment and functional reorganization after stroke and rehabilitation therapy. DOI: 10.3969/j.issn.1672-6731.2017.12.005http://www.cjcnn.org/index.php/cjcnn/article/view/1703StrokeBrain ischemiaMotor cortexMagnetic resonance imaging