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Journal of the Korean Academy of Rehabilitation Medicine 2001;25(6):907-915.
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
1Department of Rehabilitation Medicine, Keimyung University School of Medicine, Korea.
2Department of Neurology, Keimyung University School of Medicine, Korea.
3Department of Radiology, Keimyung University School of Medicine, Korea.
4Department of Radiology, Kyungpook National University College of Medicine, Korea.
대뇌 피질하 뇌졸중 환자의 손 운동 회복에 대한 기능적 뇌 자기공명영상 소견
박기영, 이소영, 이상도1, 손철호2, 한봉수3
계명대학교 의과대학 재활의학교실, 1신경과학교실, 2진단방사선과학교실, 3경북대학교 의과대학 진단방사선과 의학영상연구실
Abstract

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.

Key Words: Functional MRI, Subcortical stroke, Reorganization, Restoration of neurologic function


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