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Journal of the Korean Academy of Rehabilitation Medicine 2004;28(5):412-417.
Influence of Lesion Location on Cortical Recovery Pattern in Hemiparetic Stroke Patients.
Jang, Sung Ho , Son, Su Min , Ahn, Sang Ho , Cho, Sang Hyun , Jang, Han Won , Cho, Yun Woo , Yang, Dong Seok , Lee, Dong Gyu
1Department of Physical Medicine and Rehabilitation, Yeungnam University College of Medicine, Korea. sumin430@hanmail.net
2Department of Physical Therapy, Yonsei University College of Health Science, Korea.
3Department of Diagnostic Radiology, Yeungnam University College of Medicine, Korea.
뇌경색 환자의 병변 위치에 따른 운동신경기능 회복기전
장성호, 손수민, 안상호, 조상현1, 장한원2, 조윤우, 양동석, 이동규
영남대학교 의과대학 재활의학교실, 1연세대학교 보건과학대학 재활학과, 2영남대학교 의과대학 방사선학교실
The aim of this study was to elucidate how the location of cerebral infarct influences cortical recovery pattern in hemiparetic stroke patients.
Forty-three chronic stroke patients and 21 control subjects were recruited for the study. The patients were classified into 4 groups according to infarct locations: cortex (CO), corona radiata (CR), posterior limb of the internal capsule (PL), and brainstem (BS). Functional MRI was performed using the blood oxygen level-dependent technique at 1.5 T with the motor task of hand grasp-release movements.
The activation pattern of the primary sensori-motor cortex (SM1) was found to be significantly influenced by the lesion locations, but that of the secondary motor area was not (Pearson's chi-square test, p<0.05). The 'contralateral' SM1 activation was the major response in the control group (85.7%) and in the BS group (75.0%). On the other hand, the major activation pattern was 'peri-lesional' in the CO group (peri-lesional 57.1%, peri-lesional and ipsilateral 42.9%), 'bilateral activation' in the CR (85.7%) and the PL group (100.0%).
Our results suggested that motor recovery mechanisms could be different according to location of cerebral infarct. (J Korean Acad Rehab Med 2004; 28: 412-417)
Key Words: Functional magnetic resonance imaging, Stroke, Motor recovery, Hemiplegia


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