Dataset Information

Stroke Lesion Volume and Injury to Motor Cortex Output Determines Extent of Contralesional Motor Cortex Reorganization.

ABSTRACT:

Background

After stroke, increases in contralesional primary motor cortex (M1_CL) activity and excitability have been reported. In pre-clinical studies, M1_CL reorganization is related to the extent of ipsilesional M1 (M1_IL) injury, but this has yet to be tested clinically.

Objectives

We tested the hypothesis that the extent of damage to the ipsilesional M1 and/or its corticospinal tract (CST) determines the magnitude of M1_CL reorganization and its relationship to affected hand function in humans recovering from stroke.

Methods

Thirty-five participants with a single subacute ischemic stroke affecting M1 or CST and hand paresis underwent MRI scans of the brain to measure lesion volume and CST lesion load. Transcranial magnetic stimulation (TMS) of M1_IL was used to determine the presence of an electromyographic response (motor evoked potential (MEP+ and MEP-)). M1_CL reorganization was determined by TMS applied to M1_CL at increasing intensities. Hand function was quantified with the Jebsen Taylor Hand Function Test.

Results

The extent of M1_CL reorganization was related to greater lesion volume in the MEP- group, but not in the MEP+ group. Greater M1_CL reorganization was associated with more impaired hand function in MEP- but not MEP+ participants. Absence of an MEP (MEP-), larger lesion volumes and higher lesion loads in CST, particularly in CST fibers originating in M1 were associated with greater impairment of hand function.

Conclusions

In the subacute post-stroke period, stroke volume and M1_IL output determine the extent of M1_CL reorganization and its relationship to affected hand function, consistent with pre-clinical evidence.ClinicalTrials.gov Identifier: NCT02544503.

SUBMITTER: Buetefisch CM

PROVIDER: S-EPMC10079613 | biostudies-literature | 2023 Feb-Mar

REPOSITORIES: biostudies-literature

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Publications

Stroke Lesion Volume and Injury to Motor Cortex Output Determines Extent of Contralesional Motor Cortex Reorganization.

Buetefisch Cathrin M CM Haut Marc W MW Revill Kate P KP Shaeffer Scott S Edwards Lauren L Barany Deborah A DA Belagaje Samir R SR Nahab Fadi F Shenvi Neeta N Easley Kirk K

Neurorehabilitation and neural repair 20230214 2-3

<h4>Background</h4>After stroke, increases in contralesional primary motor cortex (M1<sub>CL</sub>) activity and excitability have been reported. In pre-clinical studies, M1<sub>CL</sub> reorganization is related to the extent of ipsilesional M1 (M1<sub>IL</sub>) injury, but this has yet to be tested clinically.<h4>Objectives</h4>We tested the hypothesis that the extent of damage to the ipsilesional M1 and/or its corticospinal tract (CST) determines the magnitude of M1<sub>CL</sub> reorganizatio ...[more]

PMID: 36786394

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Project description:The anterolateral motor cortex of rodents is an important motor auxiliary area, and its function is similar to that of the premotor area in humans. Activation and inhibition of the contralesional anterolateral motor cortex (cALM) have been shown to have direct effects on motor behavior. However, the significance of cALM activation and inhibition in the treatment of stroke remains unclear. This study investigated the role of optogenetic cALM stimulation in a mouse model of cerebral stroke. The results showed that 21-day optogenetic cALM inhibition, but not activation, improved neurological function. In addition, optogenetic cALM stimulation substantially altered dendritic structural reorganization and dendritic spine plasticity, as optogenetic cALM inhibition resulted in increased dendritic length, number of dendritic spines, and number of perforated synapses, whereas optogenetic activation led to an increase in the number of multiple synapse boutons and the number of dendritic intersections. Furthermore, RNA-seq analysis showed that multiple biological processes regulated by the cALM were upregulated immediately after optogenetic cALM inhibition, and that several immediate-early genes (including cFOS, Erg1, and Sema3f) were expressed at higher levels after optogenetic inhibition than after optogenetic activation. These results were confirmed by quantitative reverse transcription-polymerase chain reaction. Finally, immunofluorescence analysis showed that the c-FOS signal in layer V of the primary motor cortex in the ischemic hemisphere was higher after optogenetic cALM activation than it was after optogenetic cALM inhibition. Taken together, these findings suggest that optogenetic cALM stimulation promotes neural reorganization in the primary motor cortex of the ischemic hemisphere, and that optogenetic cALM inhibition and activation have different effects on neural plasticity. The study was approved by the Experimental Animal Ethics Committee of Fudan University (approval No. 201802173S) on March 3, 2018.

Dataset Information

Stroke Lesion Volume and Injury to Motor Cortex Output Determines Extent of Contralesional Motor Cortex Reorganization.

Background

Objectives

Methods

Results

Conclusions

Publications

Stroke Lesion Volume and Injury to Motor Cortex Output Determines Extent of Contralesional Motor Cortex Reorganization.

Similar Datasets

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