한빛사 논문
성균관대학교 의과대학
Chang-hyun Park, PhD, Won Hyuk Chang, MD, Suk Hoon Ohn, MD, Sung Tae Kim, MD, Oh Young Bang, MD, PhD, Alvaro Pascual-Leone, MD, PhD, and Yun-Hee Kim, MD, PhD
From the Samsung Biomedical Research Institute (C.-H.P.), Samsung Medical Center, Seoul, Korea; the Departments of Physical and Rehabilitation Medicine (W.H.C., Y.-H.K.), Diagnostic Radiology and Imaging Science (S.T.K.), and Neurology (O.Y.B.), Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea; the Department of Physical Medicine and Rehabilitation (S.H.O.), Hallym University College of Medicine, Seoul, Korea; and the Berenson-Allen Center for Noninvasive Brain Stimulation (A.P.-L.), Beth Israel Deaconess Medical Center, Boston, MA.
Correspondence to Yun-Hee Kim, MD, PhD
Abstract
Background and Purpose—
Functional MRI (fMRI) studies could provide crucial information on the neural mechanisms of motor recovery in patients with stroke. Resting-state fMRI is applicable to patients with stroke who are not capable of proper performance of the motor task. In this study, we explored neural correlates of motor recovery in patients with stroke by investigating longitudinal changes in resting-state functional connectivity of the ipsilesional primary motor cortex (M1).
Methods—
A longitudinal observational study using repeated fMRI experiments was conducted in 12 patients with stroke. Resting-state fMRI data were acquired 4 times over a period of 6 months. Patients participated in the first session of fMRI shortly after onset and thereafter in subsequent sessions at 1, 3, and 6 months after onset. Resting-state functional connectivity of the ipsilesional M1 was assessed and compared with that of healthy subjects.
Results—
Compared with healthy subjects, patients demonstrated higher functional connectivity with the ipsilesional frontal and parietal cortices, bilateral thalamus, and cerebellum. Instead, functional connectivity with the contralesional M1 and occipital cortex were decreased in patients with stroke. Functional connectivity between the ipsilesional and contralesional M1 showed the most asymmetry at 1 month after onset to the ipsilesional side. Functional connectivity of the ipsilesional M1 with the contralesional thalamus, supplementary motor area, and middle frontal gyrus at onset was positively correlated with motor recovery at 6 months after stroke.
Conclusions—
Resting-state fMRI elicited distinctive but comparable results with previous task-based fMRI, presenting complementary and practical values for use in the study of patients with stroke.
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