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Brain Structure and Function

, Volume 220, Issue 5, pp 2533–2550

First Online: 07 June 2014Received: 27 November 2013Accepted: 17 May 2014

Abstract

Preclinical studies using animal models have shown that grey matter plasticity in both perilesional and distant neural networks contributes to behavioural recovery of sensorimotor functions after ischaemic cortical stroke. Whether such morphological changes can be detected after human cortical stroke is not yet known, but this would be essential to better understand post-stroke brain architecture and its impact on recovery. Using serial behavioural and high-resolution magnetic resonance imaging MRI measurements, we tracked recovery of dexterous hand function in 28 patients with ischaemic stroke involving the primary sensorimotor cortices. We were able to classify three recovery subgroups fast, slow, and poor using response feature analysis of individual recovery curves. To detect areas with significant longitudinal grey matter volume GMV change, we performed tensor-based morphometry of MRI data acquired in the subacute phase, i.e. after the stage compromised by acute oedema and inflammation. We found significant GMV expansion in the perilesional premotor cortex, ipsilesional mediodorsal thalamus, and caudate nucleus, and GMV contraction in the contralesional cerebellum. According to an interaction model, patients with fast recovery had more perilesional than subcortical expansion, whereas the contrary was true for patients with impaired recovery. Also, there were significant voxel-wise correlations between motor performance and ipsilesional GMV contraction in the posterior parietal lobes and expansion in dorsolateral prefrontal cortex. In sum, perilesional GMV expansion is associated with successful recovery after cortical stroke, possibly reflecting the restructuring of local cortical networks. Distant changes within the prefrontal-striato-thalamic network are related to impaired recovery, probably indicating higher demands on cognitive control of motor behaviour.

KeywordsCortical stroke Grey matter plasticity Tensor-based morphometry Motor recovery E. Abela and A. Seiler have contributed equally to this work.

B. J. Weder and R. Wiest share senior authorship.

Electronic supplementary materialThe online version of this article doi:10.1007-s00429-014-0804-y contains supplementary material, which is available to authorized users.

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Author: E. Abela - A. Seiler - J. H. Missimer - A. Federspiel - C. W. Hess - M. Sturzenegger - B. J. Weder - R. Wiest

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