Early imaging correlates of subsequent motor recovery after stroke

Ann Neurol. 2009 May;65(5):596-602. doi: 10.1002/ana.21636.


Objective: To determine whether functional magnetic resonance imaging activation obtained in the first few days after stroke correlates with subsequent motor recovery.

Methods: Twenty-three patients with hemiparesis after first-time stroke were scanned at 2.0 +/- 0.9 days while performing a simple motor task. We defined recovery as the change in Fugl-Meyer score from time of scan to approximately 3 months later (90 +/- 8 days). We performed three different tests to assess correlations between brain activation and change in Fugl-Meyer score: (1) multivariate (most sensitive to spatially diffuse activation); (2) voxel-wise Statistical Parametric Mapping (most sensitive to focal activation), and (3) primary motor cortex region-of-interest analysis (most sensitive to average activation within this region). All tests controlled for initial stroke severity and lesion volume, as well as other established clinical variables.

Results: The multivariate test was significant [F (595, 4,934) = 1.93; p < 0.001]. The Statistical Parametric Mapping test detected two small clusters of focal activity located in the ipsilesional postcentral gyrus and cingulate cortex (p < 0.05, corrected). The region-of-interest test was not significant.

Interpretation: There is a pattern of brain activation present in the first few days after stroke, of which the postcentral gyrus and cingulate cortex are a part, that correlates with subsequent motor recovery. This result suggests that there are recovery processes engaged early after stroke that could provide a target for intervention.

Publication types

  • Research Support, N.I.H., Extramural

MeSH terms

  • Adult
  • Aged
  • Brain* / blood supply
  • Brain* / pathology
  • Brain* / physiopathology
  • Female
  • Functional Laterality
  • Humans
  • Image Processing, Computer-Assisted
  • Magnetic Resonance Imaging*
  • Male
  • Middle Aged
  • Movement Disorders / etiology*
  • Movement Disorders / pathology*
  • Neural Pathways / blood supply
  • Neural Pathways / pathology
  • Neural Pathways / physiopathology
  • Oxygen / blood
  • Recovery of Function / physiology*
  • Retrospective Studies
  • Statistics as Topic
  • Stroke / complications*
  • Time Factors


  • Oxygen