ABSTRACT

Objective : Our brain have a capacity to recover and to reorganize its functions from the damage spontaneously from the damage. Recovery of motor function occur in the most stroke patients, which is related with reorganization of neural networks. Several investigations revealed that these changes of neural networks could have the differential activation patterns according to the lesion location. So we reported the differences of the cortical activation pattern between patients with focal infarction on the cortex or the corona radiata.Methods : We selected four stroke patients which consisted of 2 patients with the precentral knob injured and 2 patients with corona radiata injured, and seven normal volunteer without history of neurological dysfunction were recruited. All subjects were scanned during motor task of hand flexion-extension in 1.5T MRI equipment, and at the time, evaluated by the motor function of the hand such as the MRC, Grip strength, the Purdue pegboard and the mirror movement. We compared the differences of cortical activation according to the differential brain lesion.Results : Although patients have nearly similar the hand motor function one another, there was significant different cortical activation pattern depending on the cerebral infarct location. The only contralateral activation was shown in patients with the lesion of the cerebral cortex like the pattern of normal subjects, whereas bilateral primary motor cortex was activated in patients with the injury of the corona radiata.Conclusion : Brain lesions were classified into two categories, the cerebral cortex and the corona radiata. Although all patients had the recovery up to the similar extent of hand motor function, closed to almost normal state, the different cortical activation patterns were founded. The findings provides rehabilitative clinicians with an important message for therapeutic intervention of paretic hand in the field of multimodal and interdisciplinary neurorehabilitation.