Motor recovery as assessed with isometric finger movements and perfusion magnetic resonance imaging after acute ischemic stroke.
OBJECTIVE
Recovery from hemiparetic stroke is variable. An important goal for clinicians and clinical researchers is to identify predictors of recovery. The initial phase after acute ischemic stroke is considered to be of major importance for neurological outcome. The authors sought to determine in patients with acute ischemic stroke whether early motor recovery, as measured by repetitive isometric index-thumb oppositions, is correlated with ischemic lesion volume.


METHODS
Thirty-six acute hemiparetic stroke patients with residual hand function were investigated. The European Stroke Scale (ESS) score was determined on admission and at discharge. Performance of repetitive index finger-thumb pinch movements was measured daily during the 1st 8 days after stroke onset. Brain ischemia volume was determined digitally in time-to-peak magnetic resonance images of per-fusion.


RESULTS
The recovery of patients with (P = 0.002) and without (P < 0.001) thrombolysis as assessed with the ESS was paralleled by an increase in isometric grip force and movement rate (P < 0.05). Recovery was predicted by the area of moderately impaired perfusion indicated by the per-fusion mismatch volume (r = 0.578, P < 0.001).


CONCLUSIONS
In acute stroke, recovery of hand function is predicted by the volume of salvageable ischemic tissue, as determined by the perfusion mismatch.
Weller
Patrick
P
Department of Neurology, University Hospital Düsseldorf, Düsseldorf, Germany.
Wittsack
Hans-Jörg
HJ
Siebler
Mario
M
Hömberg
Volker
V
Seitz
Rüdiger J
RJ
D000368:Aged; D002545:Brain Ischemia / Q000150:complications / Q000175:diagnosis / Q000503:physiopathology; D005260:Female; D005385:Fingers / Q000503:physiopathology*; D006801:Humans; D007537:Isometric Contraction / Q000502:physiology*; D018810:Magnetic Resonance Angiography; D008297:Male; D008875:Middle Aged; D009043:Motor Activity / Q000502:physiology*; D011237:Predictive Value of Tests; D020127:Recovery of Function / Q000502:physiology; D020521:Stroke / Q000209:etiology / Q000473:pathology* / Q000503:physiopathology*