title: Premotor cortex is involved in restoration of gait in stroke.
abstract: Cortical activation during hemiplegic gait was assessed in six nonambulatory patients with severe stroke (four men, two women; four with right and two with left hemiplegia; 57 years old and 3 months after stroke on average), using a near-infrared spectroscopic imaging system. Each patient performed tasks of treadmill walking (0.2km/hr), alternated with rest every 30 seconds for four repetitions, under partial body weight support, either with mechanical assistance in swinging the paretic leg control (CON) or with a facilitation technique that enhanced swinging of the paretic leg (FT), provided by physical therapists. Gait performance was associated with increased oxygenated hemoglobin levels in the medial primary sensorimotor cortex in the unaffected hemisphere greater than in the affected hemisphere. Both cortical mappings and quantitative data showed that the premotor activation in the affected hemisphere was enhanced during hemiplegic gait. There was also a prominent activation in the presupplementary motor area. Overall cortical activations and gait performance were greater in walking with FT than with CON. These indicate that multiple motor areas including the premotor cortex and presupplementary motor area might play important roles in restoration of gait in patients with severe stroke.
authors.affiliation: Neurorehabilitation Research Institute, Bobath Memorial Hospital, Osaka., Japan. webeo@ga.2.so-net.ne.jp
authors.forename: Ichiro
authors.initials: I
authors.lastname: Miyai
authors.forename: Hajime
authors.initials: H
authors.lastname: Yagura
authors.forename: Ichiro
authors.initials: I
authors.lastname: Oda
authors.forename: Ikuo
authors.initials: I
authors.lastname: Konishi
authors.forename: Hideo
authors.initials: H
authors.lastname: Eda
authors.forename: Tsunehiko
authors.initials: T
authors.lastname: Suzuki
authors.forename: Kisou
authors.initials: K
authors.lastname: Kubota
mesh_terms: D000328:Adult; D000368:Aged; D001931:Brain Mapping; D005260:Female; D005684:Gait; D006429:Hemiplegia / Q000503:physiopathology; D006801:Humans; D008297:Male; D008875:Middle Aged; D009044:Motor Cortex / Q000098:blood supply / Q000503:physiopathology*; D010108:Oxyhemoglobins / Q000032:analysis; D012720:Severity of Illness Index; D013003:Somatosensory Cortex / Q000098:blood supply; D019265:Spectroscopy, Near-Infrared; D020521:Stroke / Q000503:physiopathology*; D016138:Walking
chemical_list: D010108:Oxyhemoglobins