Recovery of Upper Limb Function After Cerebellar Stroke Lesion Symptom Mapping and Arm Kinematics
Identifieur interne : 000D00 ( Main/Exploration ); précédent : 000C99; suivant : 000D01Recovery of Upper Limb Function After Cerebellar Stroke Lesion Symptom Mapping and Arm Kinematics
Auteurs : Jürgen Konczak [États-Unis] ; Daniela Pierscianek [Allemagne] ; Sarah Hirsiger [États-Unis, Suisse] ; Uta Bultmann [Allemagne] ; Beate Schoch [Allemagne] ; Elke R. Gizewski [Allemagne] ; Dagmar Timmann [Allemagne] ; Matthias Maschke [Allemagne] ; Markus Frings [Allemagne]Source :
- Stroke : (1970) [ 0039-2499 ] ; 2010.
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- Pascal (Inist)
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- topic : Cartographie, Homme.
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Abstract
Background and Purpose-Loss of movement coordination is the main postacute symptom after cerebellar infarction. Although the course of motor recovery has been described previously, detailed kinematic descriptions of acute stage ataxia are rare and no attempt has been made to link improvements in motor function to measures of neural recovery and lesion location. This study provides a comprehensive assessment of how lesion site and arm dysfunction are associated in the acute stage and outlines the course of upper limb motor recovery for the first 4 months after the infarction. Methods-Sixteen adult patients with cerebellar stroke and 11 age-matched healthy controls participated. Kinematics of goal-directed and unconstrained finger-pointing movements were measured at the acute stage and in 2-week and 3-month follow-ups. MRI data were obtained for the acute and 3-month follow-up sessions. A voxel-based lesion map subtraction analysis was performed to examine the effect of ischemic lesion sites on kinematic performance. Results-In the acute stage, nearly 70% of patients exhibited motor slowing with hand velocity and acceleration maxima below the range of the control group. MRI analysis revealed that in patients with impaired motor performance, lesions were more common in paravermal lobules IVN and affected the deep cerebellar nuclei. Stroke affecting the superior cerebellar artery led to lower motor performance than infractions of the posterior cerebellar artery. By the 2-week-follow-up, hand kinematics had improved dramatically (gains in acceleration up to 86%). Improvements between the 2-week and the 3-month-follow-ups were less pronounced. Conclusion-In the acute stage, arm movements were mainly characterized by abnormal slowness (bradykinesia) and not dyscoordination (ataxia). The motor signs were associated with lesions in paravermal regions of lobules IVN and the deep cerebellar nuclei. Motor recovery was fast, with the majority of gains in upper limb function occurring in the first 2 weeks after the acute phase.
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Gizewski</name><affiliation wicri:level="1"><inist:fA14 i1="05"><s1>Department of Neuroradiology, University of Duisburg-Essen</s1><s2>Essen</s2><s3>DEU</s3><sZ>6 aut.</sZ></inist:fA14><country>Allemagne</country><wicri:noRegion>Essen</wicri:noRegion><wicri:noRegion>University of Duisburg-Essen</wicri:noRegion><wicri:noRegion>Essen</wicri:noRegion></affiliation><affiliation wicri:level="1"><inist:fA14 i1="06"><s1>Department of Neuroradiology, UKGM, Justus-Liebig University</s1><s2>Giessen</s2><s3>DEU</s3><sZ>6 aut.</sZ></inist:fA14><country>Allemagne</country><wicri:noRegion>Giessen</wicri:noRegion><wicri:noRegion>Justus-Liebig University</wicri:noRegion><wicri:noRegion>Giessen</wicri:noRegion></affiliation></author><author><name sortKey="Timmann, Dagmar" sort="Timmann, Dagmar" uniqKey="Timmann D" first="Dagmar" last="Timmann">Dagmar Timmann</name><affiliation wicri:level="1"><inist:fA14 i1="02"><s1>Department of Neurology, University of Duisburg-Essen</s1><s2>Essen</s2><s3>DEU</s3><sZ>2 aut.</sZ><sZ>4 aut.</sZ><sZ>7 aut.</sZ><sZ>9 aut.</sZ></inist:fA14><country>Allemagne</country><wicri:noRegion>Essen</wicri:noRegion><wicri:noRegion>University of Duisburg-Essen</wicri:noRegion><wicri:noRegion>Essen</wicri:noRegion></affiliation></author><author><name sortKey="Maschke, Matthias" sort="Maschke, Matthias" uniqKey="Maschke M" first="Matthias" last="Maschke">Matthias Maschke</name><affiliation wicri:level="1"><inist:fA14 i1="07"><s1>Department of Neurology, Briiderkrankenhaus</s1><s2>Trier</s2><s3>DEU</s3><sZ>8 aut.</sZ></inist:fA14><country>Allemagne</country><wicri:noRegion>Trier</wicri:noRegion><wicri:noRegion>Briiderkrankenhaus</wicri:noRegion><wicri:noRegion>Trier</wicri:noRegion></affiliation></author><author><name sortKey="Frings, Markus" sort="Frings, Markus" uniqKey="Frings M" first="Markus" last="Frings">Markus Frings</name><affiliation wicri:level="1"><inist:fA14 i1="02"><s1>Department of Neurology, University of Duisburg-Essen</s1><s2>Essen</s2><s3>DEU</s3><sZ>2 aut.</sZ><sZ>4 aut.</sZ><sZ>7 aut.</sZ><sZ>9 aut.</sZ></inist:fA14><country>Allemagne</country><wicri:noRegion>Essen</wicri:noRegion><wicri:noRegion>University of Duisburg-Essen</wicri:noRegion><wicri:noRegion>Essen</wicri:noRegion></affiliation></author></titleStmt><publicationStmt><idno type="wicri:source">INIST</idno><idno type="inist">10-0476192</idno><date when="2010">2010</date><idno type="stanalyst">PASCAL 10-0476192 INIST</idno><idno type="RBID">Pascal:10-0476192</idno><idno type="wicri:Area/PascalFrancis/Corpus">000512</idno><idno type="wicri:Area/PascalFrancis/Curation">000871</idno><idno type="wicri:Area/PascalFrancis/Checkpoint">000367</idno><idno type="wicri:explorRef" wicri:stream="PascalFrancis" wicri:step="Checkpoint">000367</idno><idno type="wicri:doubleKey">0039-2499:2010:Konczak J:recovery:of:upper</idno><idno type="wicri:Area/Main/Merge">000D58</idno><idno type="wicri:Area/Main/Curation">000D00</idno><idno type="wicri:Area/Main/Exploration">000D00</idno></publicationStmt><sourceDesc><biblStruct><analytic><title xml:lang="en" level="a">Recovery of Upper Limb Function After Cerebellar Stroke Lesion Symptom Mapping and Arm Kinematics</title><author><name sortKey="Konczak, Jurgen" sort="Konczak, Jurgen" uniqKey="Konczak J" first="Jürgen" last="Konczak">Jürgen Konczak</name><affiliation wicri:level="1"><inist:fA14 i1="01"><s1>Human Sensorimotor Control Laboratory, University of Minnesota</s1><s2>Minneapolis, Mn</s2><s3>USA</s3><sZ>1 aut.</sZ><sZ>3 aut.</sZ></inist:fA14><country>États-Unis</country><wicri:noRegion>Minneapolis, Mn</wicri:noRegion></affiliation></author><author><name sortKey="Pierscianek, Daniela" sort="Pierscianek, Daniela" uniqKey="Pierscianek D" first="Daniela" last="Pierscianek">Daniela Pierscianek</name><affiliation wicri:level="1"><inist:fA14 i1="02"><s1>Department of Neurology, University of Duisburg-Essen</s1><s2>Essen</s2><s3>DEU</s3><sZ>2 aut.</sZ><sZ>4 aut.</sZ><sZ>7 aut.</sZ><sZ>9 aut.</sZ></inist:fA14><country>Allemagne</country><wicri:noRegion>Essen</wicri:noRegion><wicri:noRegion>University of Duisburg-Essen</wicri:noRegion><wicri:noRegion>Essen</wicri:noRegion></affiliation></author><author><name sortKey="Hirsiger, Sarah" sort="Hirsiger, Sarah" uniqKey="Hirsiger S" first="Sarah" last="Hirsiger">Sarah Hirsiger</name><affiliation wicri:level="1"><inist:fA14 i1="01"><s1>Human Sensorimotor Control Laboratory, University of Minnesota</s1><s2>Minneapolis, Mn</s2><s3>USA</s3><sZ>1 aut.</sZ><sZ>3 aut.</sZ></inist:fA14><country>États-Unis</country><wicri:noRegion>Minneapolis, Mn</wicri:noRegion></affiliation><affiliation wicri:level="3"><inist:fA14 i1="03"><s1>Institute of Human Movement Sciences and Sport ETH Zürich</s1><s2>Zürich</s2><s3>CHE</s3><sZ>3 aut.</sZ></inist:fA14><country>Suisse</country><placeName><settlement type="city">Zurich</settlement><region nuts="3" type="region">Canton de Zurich</region></placeName></affiliation></author><author><name sortKey="Bultmann, Uta" sort="Bultmann, Uta" uniqKey="Bultmann U" first="Uta" last="Bultmann">Uta Bultmann</name><affiliation wicri:level="1"><inist:fA14 i1="02"><s1>Department of Neurology, University of Duisburg-Essen</s1><s2>Essen</s2><s3>DEU</s3><sZ>2 aut.</sZ><sZ>4 aut.</sZ><sZ>7 aut.</sZ><sZ>9 aut.</sZ></inist:fA14><country>Allemagne</country><wicri:noRegion>Essen</wicri:noRegion><wicri:noRegion>University of Duisburg-Essen</wicri:noRegion><wicri:noRegion>Essen</wicri:noRegion></affiliation></author><author><name sortKey="Schoch, Beate" sort="Schoch, Beate" uniqKey="Schoch B" first="Beate" last="Schoch">Beate Schoch</name><affiliation wicri:level="1"><inist:fA14 i1="04"><s1>Department of Neurosurgery, University of Duisburg-Essen</s1><s2>Essen</s2><s3>DEU</s3><sZ>5 aut.</sZ></inist:fA14><country>Allemagne</country><wicri:noRegion>Essen</wicri:noRegion><wicri:noRegion>University of Duisburg-Essen</wicri:noRegion><wicri:noRegion>Essen</wicri:noRegion></affiliation></author><author><name sortKey="Gizewski, Elke R" sort="Gizewski, Elke R" uniqKey="Gizewski E" first="Elke R." last="Gizewski">Elke R. Gizewski</name><affiliation wicri:level="1"><inist:fA14 i1="05"><s1>Department of Neuroradiology, University of Duisburg-Essen</s1><s2>Essen</s2><s3>DEU</s3><sZ>6 aut.</sZ></inist:fA14><country>Allemagne</country><wicri:noRegion>Essen</wicri:noRegion><wicri:noRegion>University of Duisburg-Essen</wicri:noRegion><wicri:noRegion>Essen</wicri:noRegion></affiliation><affiliation wicri:level="1"><inist:fA14 i1="06"><s1>Department of Neuroradiology, UKGM, Justus-Liebig University</s1><s2>Giessen</s2><s3>DEU</s3><sZ>6 aut.</sZ></inist:fA14><country>Allemagne</country><wicri:noRegion>Giessen</wicri:noRegion><wicri:noRegion>Justus-Liebig University</wicri:noRegion><wicri:noRegion>Giessen</wicri:noRegion></affiliation></author><author><name sortKey="Timmann, Dagmar" sort="Timmann, Dagmar" uniqKey="Timmann D" first="Dagmar" last="Timmann">Dagmar Timmann</name><affiliation wicri:level="1"><inist:fA14 i1="02"><s1>Department of Neurology, University of Duisburg-Essen</s1><s2>Essen</s2><s3>DEU</s3><sZ>2 aut.</sZ><sZ>4 aut.</sZ><sZ>7 aut.</sZ><sZ>9 aut.</sZ></inist:fA14><country>Allemagne</country><wicri:noRegion>Essen</wicri:noRegion><wicri:noRegion>University of Duisburg-Essen</wicri:noRegion><wicri:noRegion>Essen</wicri:noRegion></affiliation></author><author><name sortKey="Maschke, Matthias" sort="Maschke, Matthias" uniqKey="Maschke M" first="Matthias" last="Maschke">Matthias Maschke</name><affiliation wicri:level="1"><inist:fA14 i1="07"><s1>Department of Neurology, Briiderkrankenhaus</s1><s2>Trier</s2><s3>DEU</s3><sZ>8 aut.</sZ></inist:fA14><country>Allemagne</country><wicri:noRegion>Trier</wicri:noRegion><wicri:noRegion>Briiderkrankenhaus</wicri:noRegion><wicri:noRegion>Trier</wicri:noRegion></affiliation></author><author><name sortKey="Frings, Markus" sort="Frings, Markus" uniqKey="Frings M" first="Markus" last="Frings">Markus Frings</name><affiliation wicri:level="1"><inist:fA14 i1="02"><s1>Department of Neurology, University of Duisburg-Essen</s1><s2>Essen</s2><s3>DEU</s3><sZ>2 aut.</sZ><sZ>4 aut.</sZ><sZ>7 aut.</sZ><sZ>9 aut.</sZ></inist:fA14><country>Allemagne</country><wicri:noRegion>Essen</wicri:noRegion><wicri:noRegion>University of Duisburg-Essen</wicri:noRegion><wicri:noRegion>Essen</wicri:noRegion></affiliation></author></analytic><series><title level="j" type="main">Stroke : (1970)</title><title level="j" type="abbreviated">Stroke : (1970)</title><idno type="ISSN">0039-2499</idno><imprint><date when="2010">2010</date></imprint></series></biblStruct></sourceDesc><seriesStmt><title level="j" type="main">Stroke : (1970)</title><title level="j" type="abbreviated">Stroke : (1970)</title><idno type="ISSN">0039-2499</idno></seriesStmt></fileDesc><profileDesc><textClass><keywords scheme="KwdEn" xml:lang="en"><term>Ataxia</term><term>Cartography</term><term>Cerebellum</term><term>Cerebrovascular disease</term><term>Encephalon</term><term>Human</term><term>Kinematics</term><term>Nervous system diseases</term><term>Stroke</term><term>Upper limb</term></keywords><keywords scheme="Pascal" xml:lang="fr"><term>Accident cérébrovasculaire</term><term>Ataxie</term><term>Pathologie du système nerveux</term><term>Pathologie cérébrovasculaire</term><term>Membre supérieur</term><term>Cervelet</term><term>Cartographie</term><term>Cinématique</term><term>Encéphale</term><term>Homme</term></keywords><keywords scheme="Wicri" type="topic" xml:lang="fr"><term>Cartographie</term><term>Homme</term></keywords></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en">Background and Purpose-Loss of movement coordination is the main postacute symptom after cerebellar infarction. Although the course of motor recovery has been described previously, detailed kinematic descriptions of acute stage ataxia are rare and no attempt has been made to link improvements in motor function to measures of neural recovery and lesion location. This study provides a comprehensive assessment of how lesion site and arm dysfunction are associated in the acute stage and outlines the course of upper limb motor recovery for the first 4 months after the infarction. Methods-Sixteen adult patients with cerebellar stroke and 11 age-matched healthy controls participated. Kinematics of goal-directed and unconstrained finger-pointing movements were measured at the acute stage and in 2-week and 3-month follow-ups. MRI data were obtained for the acute and 3-month follow-up sessions. A voxel-based lesion map subtraction analysis was performed to examine the effect of ischemic lesion sites on kinematic performance. Results-In the acute stage, nearly 70% of patients exhibited motor slowing with hand velocity and acceleration maxima below the range of the control group. MRI analysis revealed that in patients with impaired motor performance, lesions were more common in paravermal lobules IVN and affected the deep cerebellar nuclei. Stroke affecting the superior cerebellar artery led to lower motor performance than infractions of the posterior cerebellar artery. By the 2-week-follow-up, hand kinematics had improved dramatically (gains in acceleration up to 86%). Improvements between the 2-week and the 3-month-follow-ups were less pronounced. Conclusion-In the acute stage, arm movements were mainly characterized by abnormal slowness (bradykinesia) and not dyscoordination (ataxia). The motor signs were associated with lesions in paravermal regions of lobules IVN and the deep cerebellar nuclei. Motor recovery was fast, with the majority of gains in upper limb function occurring in the first 2 weeks after the acute phase.</div></front></TEI><affiliations><list><country><li>Allemagne</li><li>Suisse</li><li>États-Unis</li></country><region><li>Canton de Zurich</li></region><settlement><li>Zurich</li></settlement></list><tree><country name="États-Unis"><noRegion><name sortKey="Konczak, Jurgen" sort="Konczak, Jurgen" uniqKey="Konczak J" first="Jürgen" last="Konczak">Jürgen Konczak</name></noRegion><name sortKey="Hirsiger, Sarah" sort="Hirsiger, Sarah" uniqKey="Hirsiger S" first="Sarah" last="Hirsiger">Sarah Hirsiger</name></country><country name="Allemagne"><noRegion><name sortKey="Pierscianek, Daniela" sort="Pierscianek, Daniela" uniqKey="Pierscianek D" first="Daniela" last="Pierscianek">Daniela Pierscianek</name></noRegion><name sortKey="Bultmann, Uta" sort="Bultmann, Uta" uniqKey="Bultmann U" first="Uta" last="Bultmann">Uta Bultmann</name><name sortKey="Frings, Markus" sort="Frings, Markus" uniqKey="Frings M" first="Markus" last="Frings">Markus Frings</name><name sortKey="Gizewski, Elke R" sort="Gizewski, Elke R" uniqKey="Gizewski E" first="Elke R." last="Gizewski">Elke R. Gizewski</name><name sortKey="Gizewski, Elke R" sort="Gizewski, Elke R" uniqKey="Gizewski E" first="Elke R." last="Gizewski">Elke R. Gizewski</name><name sortKey="Maschke, Matthias" sort="Maschke, Matthias" uniqKey="Maschke M" first="Matthias" last="Maschke">Matthias Maschke</name><name sortKey="Schoch, Beate" sort="Schoch, Beate" uniqKey="Schoch B" first="Beate" last="Schoch">Beate Schoch</name><name sortKey="Timmann, Dagmar" sort="Timmann, Dagmar" uniqKey="Timmann D" first="Dagmar" last="Timmann">Dagmar Timmann</name></country><country name="Suisse"><region name="Canton de Zurich"><name sortKey="Hirsiger, Sarah" sort="Hirsiger, Sarah" uniqKey="Hirsiger S" first="Sarah" last="Hirsiger">Sarah Hirsiger</name></region></country></tree></affiliations></record>Pour manipuler ce document sous Unix (Dilib)
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