title: Size doesn't matter: cortical stroke lesion volume is not associated with upper extremity motor impairment and function in mild, chronic hemiparesis.
abstract: OBJECTIVE
  To determine (1) the relationship between lesion volume and upper extremity (UE) motor impairment using the UE section of the Fugl-Meyer (FM) assessment; and (2) the relationship between lesion volume and UE functional outcomes using the Arm Motor Ability Test (AMAT) Functional Ability (FA) and Time scales.
  
  
  METHODS
  Secondary retrospective analysis of randomized controlled trial data.
  
  
  METHODS
  Outpatient rehabilitation clinic.
  
  
  METHODS
  Subjects with chronic stroke (N=139, 83 men; mean age ± SD of all subjects, 56.7±11.2y; mean time ± SD since stroke onset, 59.6±65.6mo; 90 subjects with right hemiparesis) and stable, active, distal UE movement.
  
  
  METHODS
  Data were collected related to subjects' lesion volume and UE movement before their participation in a multicenter, randomized controlled trial.
  
  
  METHODS
  FM and AMAT.
  
  
  RESULTS
  Neither age nor lesion volume was related to FM performance. The P value for the regression coefficient of lesion volume was .045 in the AMAT FA model and .016 in the AMAT Time model. Lesion volume accounted for only an additional 1.7% (AMAT FA) to 3.1% (AMAT Time) of the variability in motor function and was not clinically meaningful.
  
  
  CONCLUSIONS
  Data suggest no relationship between lesion volume and UE impairment, and a small, clinically insignificant relationship between lesion volume and UE motor function. Stroke causes metabolic changes in intact regions and diffuse structural loss in anatomically remote regions from the infarction. These other factors may account for variance in motor outcomes after stroke.
authors: School of Health and Rehabilitation Sciences, The Ohio State University Medical Center, Columbus, OH 43210, USA. Stephen.Page@osumc.edu
authors: Stephen J
authors: SJ
authors: Page
authors: Lynne V
authors: LV
authors: Gauthier
authors: Susan
authors: S
authors: White
mesh_terms: D000368:Aged; D002908:Chronic Disease; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D009069:Movement Disorders / Q000209:etiology / Q000503:physiopathology*; D015999:Multivariate Analysis; D020521:Stroke / Q000150:complications / Q000000981:diagnostic imaging* / Q000503:physiopathology*; D013997:Time Factors; D014057:Tomography, X-Ray Computed; D034941:Upper Extremity / Q000503:physiopathology*