title: Ipsilesional motor area size correlates with functional recovery after stroke: a 6-month follow-up longitudinal TMS motor mapping study.
abstract: OBJECTIVE
  Transcranial magnetic stimulation (TMS) and measurements of upper limb function were longitudinally applied to gain further insights into processes involved in functional recovery from the acute to the chronic stage after stroke.
  
  
  METHODS
  10 acute stroke patients were monitored over 6 months behaviourally and with established TMS protocols. By using neuronavigated motor mapping, behavioural parameters, and a mixed model analysis, the role of the frontal and parietal part of the motor area of both hemispheres for functional recovery was determined.
  
  
  RESULTS
  Size and volume of the ipsilesional motor area (MAipsi) were significantly decreased in the acute phase compared to the contralesional motor area (MAcontra). Size of MAipsi, especially its frontal part, changed over time and was positively correlated with functional recovery, whereas resting motor threshold, volume of both MA or the shift of its center of gravity did not show any association with recovery.
  
  
  CONCLUSIONS
  The present data suggests the presence of a positive correlation between changes of the motor representation of the lesioned hemisphere and functional recovery after stroke. A possible interpretation is that rather (re-)activated corticomotor outputs are substrates of functional recovery after stroke than increased efficacy of residual, non-lesioned pathways.
authors.affiliation: Brain Imaging and Neurostimulation (BINS) Laboratory, Department of Neurology, University Medical Center Hamburg-Eppendorf, Martinistr, Hamburg, Germany.
authors.forename: Nils
authors.initials: N
authors.lastname: Freundlieb
authors.affiliation: Brain Imaging and Neurostimulation (BINS) Laboratory, Department of Neurology, University Medical Center Hamburg-Eppendorf, Martinistr, Hamburg, Germany.
authors.forename: Stephan
authors.initials: S
authors.lastname: Philipp
authors.affiliation: Department of Medical Biometry and Epidemiology, University Medical Center Hamburg-Eppendorf, Martinistr, Hamburg, Germany.
authors.forename: Anna
authors.initials: A
authors.lastname: Drabik
authors.affiliation: Brain Imaging and Neurostimulation (BINS) Laboratory, Department of Neurology, University Medical Center Hamburg-Eppendorf, Martinistr, Hamburg, Germany.
authors.forename: Christian
authors.initials: C
authors.lastname: Gerloff
authors.affiliation: Department of Computational Neuroscience, University Medical Center Hamburg-Eppendorf, Martinistr, Hamburg, Germany.
authors.forename: Nils D
authors.initials: ND
authors.lastname: Forkert
authors.affiliation: Brain Imaging and Neurostimulation (BINS) Laboratory, Department of Neurology, University Medical Center Hamburg-Eppendorf, Martinistr, Hamburg, Germany.
authors.forename: Friedhelm C
authors.initials: FC
authors.lastname: Hummel
mesh_terms: D000208:Acute Disease; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001931:Brain Mapping; D002908:Chronic Disease; D005260:Female; D005500:Follow-Up Studies; D007839:Functional Laterality; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D009044:Motor Cortex / Q000473:pathology / Q000503:physiopathology*; D009929:Organ Size; D020127:Recovery of Function; D020521:Stroke / Q000175:diagnosis / Q000473:pathology / Q000503:physiopathology*; D050781:Transcranial Magnetic Stimulation
keywords: Neuronavigation; motor recovery; plasticity; stroke; transcranial magnetic stimulation