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Brain Connectivity Plasticity in the Motor Network after Ischemic Stroke

DOI: 10.1155/2013/924192

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Abstract:

The motor function is controlled by the motor system that comprises a series of cortical and subcortical areas interacting via anatomical connections. The motor function will be disturbed when the stroke lesion impairs either any of these areas or their connections. More and more evidence indicates that the reorganization of the motor network including both areas and their anatomical and functional connectivity might contribute to the motor recovery after stroke. Here, we review recent studies employing models of anatomical, functional, and effective connectivity on neuroimaging data to investigate how ischemic stroke influences the connectivity of motor areas and how changes in connectivity relate to impaired function and functional recovery. We suggest that connectivity changes constitute an important pathophysiological aspect of motor impairment after stroke and important mechanisms of motor recovery. We also demonstrate that therapeutic interventions may facilitate motor recovery after stroke by modulating the connectivity among the motor areas. In conclusion, connectivity analyses improved our understanding of the mechanisms of motor recovery after stroke and may help to design hypothesis-driven treatment strategies and sensitive measures for outcome prediction in stroke patients. 1. Introduction Motor disability is the most common deficit after ischemic stroke. Following initial damage, stroke patients can usually recover to some extent, which may be related to structural and functional modifications in surviving brain tissue. Studies on stroke rats and patients have revealed that spontaneous recovery of the motor function after stroke is associated with brain plasticity [1–5]. Neuroimaging techniques, especially the multimodality MRIs, have significantly contributed to our understanding of the mechanisms of stroke recovery by characterizing brain structural and functional changes after stroke [6–10]. Electroencephalogram (EEG) has high temporal resolution; however, it exhibits low spatial resolution and cannot record signals from deep brain tissues. Positron emission tomography (PET) is a radioactive technique with a relatively low spatial resolution. However, MRI is a noninvasive technique with high spatial resolution and is especially suitable for longitudinal connectivity studies. Moreover, MRI is a multimodality imaging technique that can be used to investigate both anatomical and functional connectivities. Structural MRI studies have revealed extensive atrophy in brain regions that connect with stroke lesions. More importantly, increased

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