Altered hemodynamic responses in patients after subcortical stroke measured by functional MRI.

BACKGROUND AND PURPOSE: Blood oxygenation level-dependent (BOLD) functional MRI (fMRI) is a promising method for defining brain recovery after stroke quantitatively. Applications thus far have assumed that the BOLD hemodynamic response in patients after stroke is identical to that in healthy control...

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Main Authors: Pineiro, R, Pendlebury, S, Johansen-Berg, H, Matthews, P
Format: Journal article
Language:English
Published: 2002
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author Pineiro, R
Pendlebury, S
Johansen-Berg, H
Matthews, P
author_facet Pineiro, R
Pendlebury, S
Johansen-Berg, H
Matthews, P
author_sort Pineiro, R
collection OXFORD
description BACKGROUND AND PURPOSE: Blood oxygenation level-dependent (BOLD) functional MRI (fMRI) is a promising method for defining brain recovery after stroke quantitatively. Applications thus far have assumed that the BOLD hemodynamic response in patients after stroke is identical to that in healthy controls. However, because of local vascular compromise or more diffuse vascular disease predisposing to infarction, this assumption may not be justified after stroke. We sought to test whether patients who have suffered a lacunar stroke show BOLD fMRI response characteristics identical to those of healthy controls. METHODS: We measured the BOLD fMRI signal time course in the sensorimotor cortex contralateral to the affected hand with finger- or hand-tapping tasks for minimally or mildly impaired right-handed patients (n=12) after lacunar strokes causing limb weakness and for healthy controls (n=20). RESULTS: With a right-handed sequential finger-tapping task, the rate of rise and maximum increase of the BOLD signal in the contralateral sensorimotor cortex were > 30% lower (P< or =0.01) in the stroke patients. Similar relative decreases were found for the same task performed with the left hand. These changes were found in patients both in the hemisphere affected by stroke and in the unaffected hemisphere, suggesting that the BOLD fMRI time course differences observed arise from a diffuse functional pathology. The difference between patients and controls is not a result of age alone, since differences were not found between the younger (n=10; aged 22 to 38 years) and the older (n=10; aged 56 to 83 years) healthy controls. The effect also does not seem to be dependent on the specific hand movement task used. CONCLUSIONS: The magnitude of the BOLD fMRI response can be reduced in stroke patients even if infarcts do not involve the cortex. This may be a consequence of the stroke, but the observation that the BOLD signal time course is similar in the affected and unaffected hemispheres suggests that it also could result from preexisting pathophysiological changes in the cerebral microvasculature.
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spelling oxford-uuid:9b59d804-7790-4395-85de-5d71cceaee7f2022-03-27T00:28:09ZAltered hemodynamic responses in patients after subcortical stroke measured by functional MRI.Journal articlehttp://purl.org/coar/resource_type/c_dcae04bcuuid:9b59d804-7790-4395-85de-5d71cceaee7fEnglishSymplectic Elements at Oxford2002Pineiro, RPendlebury, SJohansen-Berg, HMatthews, PBACKGROUND AND PURPOSE: Blood oxygenation level-dependent (BOLD) functional MRI (fMRI) is a promising method for defining brain recovery after stroke quantitatively. Applications thus far have assumed that the BOLD hemodynamic response in patients after stroke is identical to that in healthy controls. However, because of local vascular compromise or more diffuse vascular disease predisposing to infarction, this assumption may not be justified after stroke. We sought to test whether patients who have suffered a lacunar stroke show BOLD fMRI response characteristics identical to those of healthy controls. METHODS: We measured the BOLD fMRI signal time course in the sensorimotor cortex contralateral to the affected hand with finger- or hand-tapping tasks for minimally or mildly impaired right-handed patients (n=12) after lacunar strokes causing limb weakness and for healthy controls (n=20). RESULTS: With a right-handed sequential finger-tapping task, the rate of rise and maximum increase of the BOLD signal in the contralateral sensorimotor cortex were > 30% lower (P< or =0.01) in the stroke patients. Similar relative decreases were found for the same task performed with the left hand. These changes were found in patients both in the hemisphere affected by stroke and in the unaffected hemisphere, suggesting that the BOLD fMRI time course differences observed arise from a diffuse functional pathology. The difference between patients and controls is not a result of age alone, since differences were not found between the younger (n=10; aged 22 to 38 years) and the older (n=10; aged 56 to 83 years) healthy controls. The effect also does not seem to be dependent on the specific hand movement task used. CONCLUSIONS: The magnitude of the BOLD fMRI response can be reduced in stroke patients even if infarcts do not involve the cortex. This may be a consequence of the stroke, but the observation that the BOLD signal time course is similar in the affected and unaffected hemispheres suggests that it also could result from preexisting pathophysiological changes in the cerebral microvasculature.
spellingShingle Pineiro, R
Pendlebury, S
Johansen-Berg, H
Matthews, P
Altered hemodynamic responses in patients after subcortical stroke measured by functional MRI.
title Altered hemodynamic responses in patients after subcortical stroke measured by functional MRI.
title_full Altered hemodynamic responses in patients after subcortical stroke measured by functional MRI.
title_fullStr Altered hemodynamic responses in patients after subcortical stroke measured by functional MRI.
title_full_unstemmed Altered hemodynamic responses in patients after subcortical stroke measured by functional MRI.
title_short Altered hemodynamic responses in patients after subcortical stroke measured by functional MRI.
title_sort altered hemodynamic responses in patients after subcortical stroke measured by functional mri
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