title: Motor cortex activation during treatment may predict therapeutic gains in paretic hand function after stroke.
abstract: OBJECTIVE
  Functional brain imaging after stroke offers insight into motor network adaptations. This exploratory study examined whether motor cortical activation captured during arm-focused therapy can predict paretic hand functional gains.
  
  
  METHODS
  Eight hemiparetic patients had serial functional MRI (fMRI) while performing a pinch task before, midway, and after 2 weeks of constraint-induced therapy. The Wolf Motor Function Test (WMFT) was performed before and after intervention.
  
  
  RESULTS
  There was a linear reduction in ipsilateral (contralesional) primary motor (M1) activation (voxel counts) across time. The midpoint M1 Laterality Index anticipated post-therapeutic change in time to perform the WMFT. The change in ipsilateral M1 voxel count (pre- to mid-) correlated with the change in mean WMFT time (pre- to post-).
  
  
  CONCLUSIONS
  The relationship between brain activation during treatment and functional gains suggests a use for serial fMRI in predicting the success and optimal duration for a focused therapeutic intervention.
authors.affiliation: Department of Biokinesiology and Physical Therapy, University of Southern California, Los Angeles, CA, USA.
authors.forename: Yun
authors.initials: Y
authors.lastname: Dong
authors.forename: Bruce H
authors.initials: BH
authors.lastname: Dobkin
authors.forename: Steven Y
authors.initials: SY
authors.lastname: Cen
authors.forename: Allan D
authors.initials: AD
authors.lastname: Wu
authors.forename: Carolee J
authors.initials: CJ
authors.lastname: Winstein
mesh_terms: D000368:Aged; D006225:Hand / Q000503:physiopathology*; D006801:Humans; D008279:Magnetic Resonance Imaging; D008875:Middle Aged; D009044:Motor Cortex / Q000503:physiopathology*; D010291:Paresis / Q000175:diagnosis / Q000209:etiology / Q000503:physiopathology* / Q000628:therapy*; D026741:Physical Therapy Modalities; D011237:Predictive Value of Tests; D020521:Stroke / Q000150:complications*