title: Atrophy of spared gray matter tissue predicts poorer motor recovery and rehabilitation response in chronic stroke.
abstract: OBJECTIVE
  Although the motor deficit after stroke is clearly due to the structural brain damage that has been sustained, this relationship is attenuated from the acute to chronic phases. We investigated the possibility that motor impairment and response to constraint-induced movement therapy in patients with chronic stroke may relate more strongly to the structural integrity of brain structures remote from the lesion than to measures of overt tissue damage.
  
  
  METHODS
  Voxel-based morphometry analysis was performed on MRI scans from 80 patients with chronic stroke to investigate whether variations in gray matter density were correlated with extent of residual motor impairment or with constraint-induced movement therapy-induced motor recovery.
  
  
  RESULTS
  Decreased gray matter density in noninfarcted motor regions was significantly correlated with magnitude of residual motor deficit. In addition, reduced gray matter density in multiple remote brain regions predicted a lesser extent of motor improvement from constraint-induced movement therapy.
  
  
  CONCLUSIONS
  Atrophy in seemingly healthy parts of the brain that are distant from the infarct accounts for at least a portion of the sustained motor deficit in chronic stroke.
authors.affiliation: Department of Physical Medicine and Rehabilitation, The Ohio State University, Columbus, OH, USA. lynnevg@gmail.com
authors.forename: Lynne V
authors.initials: LV
authors.lastname: Gauthier
authors.forename: Edward
authors.initials: E
authors.lastname: Taub
authors.forename: Victor W
authors.initials: VW
authors.lastname: Mark
authors.forename: Ameen
authors.initials: A
authors.lastname: Barghi
authors.forename: Gitendra
authors.initials: G
authors.lastname: Uswatte
mesh_terms: D000368:Aged; D001284:Atrophy; D001921:Brain / Q000473:pathology*; D002544:Cerebral Infarction / Q000473:pathology; D002908:Chronic Disease; D016000:Cluster Analysis; D005260:Female; D007839:Functional Laterality / Q000502:physiology; D006801:Humans; D007091:Image Processing, Computer-Assisted; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D009069:Movement Disorders / Q000209:etiology / Q000534:rehabilitation; D010243:Paralysis / Q000209:etiology / Q000534:rehabilitation; D010291:Paresis / Q000209:etiology / Q000534:rehabilitation; D010487:Periaqueductal Gray / Q000473:pathology; D011237:Predictive Value of Tests; D020127:Recovery of Function; D020521:Stroke / Q000473:pathology*; D000071939:Stroke Rehabilitation
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