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Reorganization of the human ipsilesional premotor cortex after stroke

Brain (London, England : 1878), 2004-04, Vol.127 (4), p.747-758 [Peer Reviewed Journal]

2004 INIST-CNRS ;Copyright Oxford University Press(England) Apr 2004 ;ISSN: 0006-8950 ;ISSN: 1460-2156 ;EISSN: 1460-2156 ;DOI: 10.1093/brain/awh082 ;PMID: 14749291 ;CODEN: BRAIAK

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Title:
Reorganization of the human ipsilesional premotor cortex after stroke
Author: Fridman, Esteban A. ; Hanakawa, Takashi ; Chung, Melissa ; Hummel, Friedhelm ; Leiguarda, Ramon C. ; Cohen, Leonardo G.
Subjects: Aged ; Aged, 80 and over ; BA = Brodmann area ; Biological and medical sciences ; Chronic Disease ; CS = corticospinal fibres ; Electromagnetic Fields ; Electromyography ; Evoked Potentials, Motor ; FDI = first dorsal interosseus ; Female ; Humans ; LICI = long‐latency intracortical inhibition ; M1 = primary motor cortex ; Magnetic Resonance Imaging ; Male ; Medical sciences ; MEP = motor evoked potential ; motor cortex ; Motor Cortex - physiopathology ; MRC = Medical Research Council ; Neurology ; Neuronal Plasticity ; ns = not significant ; PMd = dorsal premotor cortex ; PMv = ventral premotor cortex ; pre‐motor cortex ; Primates ; Psychomotor Performance ; Reaction Time ; Recovery of Function ; rehabilitation ; RMT = resting motor threshold ; RT = reaction time ; SP = silent period ; SRT = simple reaction time ; stroke ; Stroke - physiopathology ; Stroke Rehabilitation ; TMS = transcranial magnetic stimulation
Is Part Of: Brain (London, England : 1878), 2004-04, Vol.127 (4), p.747-758
Description: The substrates that mediate recovery of motor function after stroke are incompletely understood. Several primate and human studies proposed the involvement of the premotor cortex of the lesioned hemisphere. Here, we studied four chronic stroke patients with focal subcortical lesions affecting the corticospinal outflow originating in the primary motor cortex (M1) and good motor recovery. We tested the hypothesis that, in these patients, disruption of activity in the premotor cortex of the lesioned hemisphere by transcranial magnetic stimulation (TMS) would result in degraded behaviour in the paretic hand. TMS was applied to the primary motor cortex, dorsal premotor cortex (PMd) and ventral premotor cortex (PMv) of the affected (M1AH, PMdAH, PMvAH) and intact (M1IH, PMdIH, PMvIH) hemispheres of patients and healthy controls in the setting of a simple reaction time (SRT) paradigm performed with the hand contralateral to the stimulated hemisphere. TMS applied to M1 led to substantial contralateral SRT delays in both groups. TMS applied to PMdAH of patients elicited clear delays in contralateral SRT in the paretic hand, whereas TMS applied to PMdIH of patients or healthy volunteers did not. Motor evoked potentials after stimulation of PMdAH were, on average, larger and had, on average, shorter latency than after stimulation of M1AH. These results indicate that PMdAH participates as a substrate mediating functional recovery of executive motor function in patients with focal lesions of corticospinal outflow originating in M1 and good motor recovery. Our results are consistent with the hypothesis that the dorsal premotor cortex of the affected hemisphere can reorganize to control basic parameters of movement usually assigned to M1 function.
Publisher: Oxford: Oxford University Press
Language: English
Identifier: ISSN: 0006-8950
ISSN: 1460-2156
EISSN: 1460-2156
DOI: 10.1093/brain/awh082
PMID: 14749291
CODEN: BRAIAK
Source: GFMER Free Medical Journals
MEDLINE
Alma/SFX Local Collection

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Reorganization of the human ipsilesional premotor cortex after stroke

2004 INIST-CNRS ;Copyright Oxford University Press(England) Apr 2004 ;ISSN: 0006-8950 ;ISSN: 1460-2156 ;EISSN: 1460-2156 ;DOI: 10.1093/brain/awh082 ;PMID: 14749291 ;CODEN: BRAIAK

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