Annals of Rehabilitation Medicine

"Subcortical stroke"

Original Articles

Activation Pattern of the Somatosensory Cortex in Subcortical Stroke Patients with Clinical Sensory Recovery of Hand.: Lee, Zee Ihn; J Korean Acad Rehabil Med 2005;29(5):445-449.

Abstract
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Objective
To investigate the activation pattern of somatosensory cortex in subcortical stroke patients underlying recovered somatosensory capacity of hand, using functional MRI (fMRI). Method: Four patients with subcortical cerebral hemorrhage or infarction and five normal healthy volunteers were investigated. Sensory task was given on the palm of hand by brushing as a frequency of 1 Hz. In fMRI study, ten slices were obtained using the Echo Planar Imaging technique, data was statistically analyzed using SPM-99 software. Results: During the tactile stimulation of affected hand, contralateral primary somatosensory cortex was activated inall the patients. In the two patients with full recovery of tactile sense, cortical activation for paretic hand was stronger than in nonparetic hand. On the other hand, the other two patients with incomplete recovery showed that cortical activation for nonparetic hand was stronger than in paretic hand and even normal control. Conclusion: Our result suggested that functional consequences of the somatosensory cortical area were not limited to the ipsilateral hemisphere to the lesion, but affect the contralateral, nonlesioned hemisphere, in subcortical stroke patients with recovered somatosensory capacity. (J Korean Acad Rehab Med 2005; 29: 445-449)

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Functional MRI in the Recovery of Hand Movement after Subcortical Stroke.: Park, Gi Young , Lee, So Young , Lee, Sang Do , Shon, Chul Ho , Han, Bong Soo; J Korean Acad Rehabil Med 2001;25(6):907-915.

Abstract
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Objective: To investigate cortical reorganization of the brain during voluntary activities of the hand in patients with subcortical cerebral infarction.

Method: Twelve patients with first-ever subcortical brain lesion causing hemiparesis had been evaluated with functional MRI. Bilateral hand clenching was done to test voluntary hand activities. Recovery period ranged from 2 to 36 months.

Results: During the unaffected hand movement, activation of contralateral primary sensorimotor cortex (SMC) were recorded in all cases and supplmentary motor area (SMA) in 1 case. The affected hand movement showed activation of the cotralateral SMC in all cases, ipsilateral SMC in 4 cases, SMA in 4 cases and contralateral prefrontal area in 2 cases. As for the contralateral SMC, affected hand movement showed more increased activation than the unaffected. For the bilateral SMC activation during movement of the affected hand, contralateral SMC activation was greater than the ipsilateral.

Conclusion: Ipsilateral activation of the SMC, SMA, prefrontal area and increased activation of the contralateral SMC during affected hand movement suggest that these may play an important role in the reorganization of sensory and motor system in stroke patients with subcortical lesion. Functional MRI studies of patients who recovered from subcortical stroke provide evidence for several process that may be related to restoration of neurologic function.