Open AccessPeriinfarct rewiring supports recovery after primary motor cortex stroke
Author(s) -
Mitsouko van Assche,
Elisabeth Dirren,
Alexia Bourgeois,
Andreas Kleinschmidt,
Jonas Richiardi,
Emmanuel Carrera
Publication year - 2021
Publication title -
journal of cerebral blood flow and metabolism
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 2.167
H-Index - 193
eISSN - 1559-7016
pISSN - 0271-678X
DOI - 10.1177/0271678x211002968
Subject(s) - primary motor cortex , motor cortex , stroke (engine) , premotor cortex , medicine , supplementary motor area , neuroscience , corticospinal tract , physical medicine and rehabilitation , psychology , magnetic resonance imaging , functional magnetic resonance imaging , stimulation , anatomy , radiology , diffusion mri , physics , dorsum , thermodynamics
After stroke restricted to the primary motor cortex (M1), it is uncertain whether network reorganization associated with recovery involves the periinfarct or more remote regions. We studied 16 patients with focal M1 stroke and hand paresis. Motor function and resting-state MRI functional connectivity (FC) were assessed at three time points: acute (<10 days), early subacute (3 weeks), and late subacute (3 months). FC correlates of recovery were investigated at three spatial scales, (i) ipsilesional non-infarcted M1, (ii) core motor network (M1, premotor cortex (PMC), supplementary motor area (SMA), and primary somatosensory cortex), and (iii) extended motor network including all regions structurally connected to the upper limb representation of M1. Hand dexterity was impaired only in the acute phase ( P = 0.036). At a small spatial scale, clinical recovery was more frequently associated with connections involving ipsilesional non-infarcted M1 (Odds Ratio = 6.29; P = 0.036). At a larger scale, recovery correlated with increased FC strength in the core network compared to the extended motor network (rho = 0.71; P = 0.006). These results suggest that FC changes associated with motor improvement involve the perilesional M1 and do not extend beyond the core motor network. Core motor regions, and more specifically ipsilesional non-infarcted M1, could hence become primary targets for restorative therapies.