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KMID : 0361420040280050412
Journal of Korean Academy of Rehabilitation Medicine
2004 Volume.28 No. 5 p.412 ~ p.417
Influence of Lesion Location on Cortical Recovery Pattern in Hemiparetic Stroke Patients

Abstract
Objective: The aim of this study was to elucidate how the location of cerebral infarct influences cortical recovery pattern in hemiparetic stroke patients.

Method: 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.

Results: 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%).

Conclusion: Our results suggested that motor recovery mechanisms could be different according to location of cerebral infarct.
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