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The significance of sensory function for the recovery of hand paresis after ischemic stroke

English title The significance of sensory function for the recovery of hand paresis after ischemic stroke
Applicant Weder Bruno J.
Number 118018
Funding scheme Project funding (Div. I-III)
Research institution Klinik für Neurologie Kantonsspital St. Gallen
Institution of higher education Cantonal hospital of St.Gallen - KSPSG
Main discipline Neurophysiology and Brain Research
Start/End 01.01.2008 - 31.12.2010
Approved amount 260'000.00
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All Disciplines (2)

Discipline
Neurophysiology and Brain Research
Neurology, Psychiatry

Keywords (10)

hand paresis; stroke; motor recovery; sensory function; neuronal networks; neuronal reorganization; relearning; fMRI; diffusion tensor imaging; arterial spin labeling

Lay Summary (English)

Lead
Lay summary
Recovery of motor hand function after cerebral ischemic infarction takes weeks or months. Functional imaging studies of the human brain have showed evidence for the functional reorganization of neuronal networks serving the restitution of hand function. In other words, the neuronal networks responsible for our motor skills reorganize to various degrees with time in relation to the severity of a stroke. Different adaptive mechanisms have been shown in dedicated experiments: 1. activation of preserved brain areas in the neighbourhood of a lesion; 2. the enlargement of the functional motor hand areas; and, 3. the activation of the homologue brain area in the contralateral, normal cerebral hemisphere. Daily motor activity often requires the integration of sensory information. Examples of such daily activities are writing, placing pegs in holes or exploring objects tactilely. Considering the importance of daily activities, clarifying the role of sensory deficits in the reorganization of neuronal networks involved in motor recovery is a vital task. Study plan: We will investigate patients periodically during recovery from sensorimotoric stroke. Cerebral activation patterns of sensorimotoric activity during manipulation and somatosensory discrimination tasks will be assessed with functional Magnetic Resonance Imaging, fMRI, at early and late chronic stages, i.e. three and nine months after stroke. The video-monitored task performances will be correlated with the lesions, and the characteristic activation patterns recorded with a high-resolution MRI-scanner. fMRI activation patterns will be used as seeding points to determine with diffusion tensor imaging (DTI) the white matter paths connecting these areas. These brain imaging techniques will give us a window into the brain areas involved in the control and coordination of skillful motor hand activity. By comparing the cerebral patterns of patients and normal volunteers, we expect to distinguish among the neuronal networks of normal volunteers and patients and to visualize the disrupted functional networks. Finally, we address the question whether neuronal reorganization continues after the early recovery phase of three months or whether late recovery rather involves relearning lost skills.Importance of the project: Despite strong efforts and advances in acute stroke management, residual sensorimotoric deficits have a major impact on functional capability. Severe disability affects at least a third of all stroke patients during daily activities. Different motor skills depend highly on sensorimotoric integration and sensory information processing. Thus, demonstration and characterization of sensorimotoric cerebral reorganization with time related to recovery may have considerable consequences for rehabilitation programmes employing e.g. physio- or ergotherapy. Better describing and understanding the mechanisms of cerebral reorganization could therefore provide a key to new therapeutic approaches.
Direct link to Lay Summary Last update: 21.02.2013

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Associated projects

Number Title Start Funding scheme
160107 Effects of serotonergic neuromodulation on behavioural recovery and motor network plasticity after cortical ischemic stroke: a longitudinal, placebo-controlled study 01.01.2016 Project funding (Div. I-III)
160107 Effects of serotonergic neuromodulation on behavioural recovery and motor network plasticity after cortical ischemic stroke: a longitudinal, placebo-controlled study 01.01.2016 Project funding (Div. I-III)

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