Longitudinal cortical volume changes correlate with motor recovery in patients after acute local subcortical infarction.
OBJECTIVE
Secondary changes in the volume of motor-related cortical regions and the relationship with functional recovery during the acute stage after cerebral infarction have not been determined. In the present study, we quantified changes in gray matter (GM) volume in motor-related cortical regions and analyzed their correlations to clinical scores in patients with focal cerebral infarct.


METHODS
Fifteen patients with acute subcortical infarct underwent longitudinal high-resolution structural MRI and clinical assessment 3 times during a 12-week period (weeks 1, 4, and 12). Fourteen age- and sex-matched controls underwent MRI examination. Voxel-based morphometry was used to quantify changes in global GM volume; in addition, relationships between GM volume changes in volumes of interest and clinical scores were analyzed.


RESULTS
In patients with cerebral infarction, GM volumes detected by voxel-based morphometry both decreased and increased significantly in diffuse cortical regions during the observation period (P<0.001). GM volumes within volumes of interest decreased significantly in the ipsilateral supplementary motor area and contralateral insula, but they increased in the contralateral supplementary motor area over time (all P<0.017). The changes of GM volumes in the ipsilesional and contralesional supplementary motor area correlated with the changes in the Fugl-Meyer scale scores (ipsilesional, rs=0.52; P=0.048; contralesional, rs=0.74; P=0.002) and Barthel Index (ipsilesional, rs=0.56; P=0.030; contralesional, rs=0.65; P=0.009).


CONCLUSIONS
These results suggest that secondary GM changes occur in diffuse areas and structural changes in some specific motor-related cortex may inhibit or promote functional recovery after an acute subcortical cerebral infarct.
From the Department of Neurology and Stroke Center, The First Affiliated Hospital, Sun Yat-Sen University, Guangzhou, China (C.D., G.L., S.X., J.L., J.Z., L.C., Z.P., J.Z.); State Key Laboratory of Oncology in Southern China, Imaging Diagnosis and Interventional Center, Cancer Center, Sun Yat-Sen University, Guangzhou, China (C.X., K.P.); and Department of Internal Medicine, Eighth People's Hospital, Guangzhou, China (C.L.).
Chao
C
Dang
Gang
G
Liu
Shihui
S
Xing
Chuanmiao
C
Xie
Kangqiang
K
Peng
Chuo
C
Li
Jingjing
J
Li
Jian
J
Zhang
Li
L
Chen
Zhong
Z
Pei
Jinsheng
J
Zeng
D000208:Acute Disease; D000293:Adolescent; D000328:Adult; D000368:Aged; D002544:Cerebral Infarction / Q000000981:diagnostic imaging / Q000503:physiopathology*; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D009043:Motor Activity; D009044:Motor Cortex / Q000000981:diagnostic imaging / Q000503:physiopathology; D011859:Radiography; D020127:Recovery of Function; D014463:Ultrasonography
cerebral infarction; gray matter; magnetic resonance imaging; neuronal plasticity