Key result
Reduced noninfarcted motor gray matter density is linked to worse post-stroke deficits and poorer therapy response.
Observational (n=80)
BACKGROUND AND PURPOSE: Although the motor deficit after stroke is clearly due to the structural brain damage that has been sustained, this relationship is attenuated from the acute to chronic phases. We investigated the possibility that motor impairment and response to constraint-induced movement therapy in patients with chronic stroke may relate more strongly to the structural integrity of brain structures remote from the lesion than to measures of overt tissue damage. METHODS: Voxel-based morphometry analysis was performed on MRI scans from 80 patients with chronic stroke to investigate whether variations in gray matter density were correlated with extent of residual motor impairment or with constraint-induced movement therapy-induced motor recovery. RESULTS: Decreased gray matter density in noninfarcted motor regions was significantly correlated with magnitude of residual motor deficit. In addition, reduced gray matter density in multiple remote brain regions predicted a lesser extent of motor improvement from constraint-induced movement therapy. CONCLUSIONS: Atrophy in seemingly healthy parts of the brain that are distant from the infarct accounts for at least a portion of the sustained motor deficit in chronic stroke.
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Gauthier et al. (2011) conducted an observational in Chronic stroke (n=80). Decreased gray matter density in remote/noninfarcted brain regions was evaluated on Residual motor impairment and constraint-induced movement therapy-induced motor recovery. Decreased gray matter density in noninfarcted motor regions significantly correlated with residual motor deficit and predicted lesser improvement from constraint-induced movement therapy.
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