title: Brain control of functional reach in healthy adults and stroke survivors.
abstract: OBJECTIVE
  Recovery of the most basic shoulder-flexion/elbow-extension components of functional reach is critical for effective arm function following stroke. In order to understand the mechanisms of motor recovery, it is important to characterize the pattern of brain activation during the reach task.
  
  
  METHODS
  We evaluated 11 controls and 23 moderately to severely impaired chronic stroke survivors (>6 months), with impaired shoulder flexion and elbow extension. Measures were acquired for Arm Motor Ability Test (AMAT) and functional Magnetic Resonance Imaging (fMRI) during the basic shoulder/elbow reach.
  
  
  RESULTS
  First, in controls, lateralization of fMRI signal during the reach task was less pronounced in comparison to other tasks, and even further diminished after stroke (p < 0.05). Second, for the stroke group, centroid locations, for specific ipsilesional (contralateral to working limb) motor-sensory regions and for contralesional (ipsilateral to working arm) somatosensory and SMA regions, were significantly more distant from the centroid location of average healthy controls (p < 0.05). Third, both greater activation volume and greater degree of signal intensity were correlated with better motor function in stroke survivors.
  
  
  CONCLUSIONS
  These findings can be useful in guiding the development of more targeted brain training methods for recovery of impaired reach coordination.
authors.affiliation: Cleveland VA Medical Center, Neurology and Research Service, Cleveland, OH, USA Brain Rehabilitation Research Center, MR VA Medical Center, Gainesville, FL, USA Department of Neurology and McKnight Brain Institute, University of Florida, FL, USA.
authors.forename: Janis J
authors.initials: JJ
authors.lastname: Daly
authors.affiliation: Cleveland VA Medical Center, Neurology and Research Service, Cleveland, OH, USA.
authors.forename: Ken
authors.initials: K
authors.lastname: Hrovat
authors.affiliation: Department of Mathematics, Cleveland State University, Cleveland, OH, USA.
authors.forename: John
authors.initials: J
authors.lastname: Holcomb
authors.affiliation: Cleveland VA Medical Center, Neurology and Research Service, Cleveland, OH, USA Department of Neurology, Case Western Reserve University School of Medicine, Cleveland, OH, USA.
authors.forename: Svetlana
authors.initials: S
authors.lastname: Pundik
mesh_terms: D000328:Adult; D000368:Aged; D001132:Arm; D001921:Brain / Q000098:blood supply / Q000503:physiopathology*; D001931:Brain Mapping; D016022:Case-Control Studies; D005260:Female; D007839:Functional Laterality; D006801:Humans; D007091:Image Processing, Computer-Assisted; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D010100:Oxygen / Q000097:blood; D020127:Recovery of Function / Q000502:physiology*; D020521:Stroke / Q000473:pathology* / Q000503:physiopathology*; D017741:Survivors
chemical_list: D010100:Oxygen
keywords: Stroke; arm function; brain activation; brain function; functional MRI; motor control