Recovery of Upper Limb Function After Cerebellar Stroke Lesion Symptom Mapping and Arm Kinematics
Identifieur interne : 000512 ( PascalFrancis/Corpus ); précédent : 000511; suivant : 000513Recovery of Upper Limb Function After Cerebellar Stroke Lesion Symptom Mapping and Arm Kinematics
Auteurs : Jürgen Konczak ; Daniela Pierscianek ; Sarah Hirsiger ; Uta Bultmann ; Beate Schoch ; Elke R. Gizewski ; Dagmar Timmann ; Matthias Maschke ; Markus FringsSource :
- Stroke : (1970) [ 0039-2499 ] ; 2010.
Descripteurs français
- Pascal (Inist)
English descriptors
- KwdEn :
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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Format Inist (serveur)
NO : | PASCAL 10-0476192 INIST |
---|---|
ET : | Recovery of Upper Limb Function After Cerebellar Stroke Lesion Symptom Mapping and Arm Kinematics |
AU : | KONCZAK (Jürgen); PIERSCIANEK (Daniela); HIRSIGER (Sarah); BULTMANN (Uta); SCHOCH (Beate); GIZEWSKI (Elke R.); TIMMANN (Dagmar); MASCHKE (Matthias); FRINGS (Markus) |
AF : | Human Sensorimotor Control Laboratory, University of Minnesota/Minneapolis, Mn/Etats-Unis (1 aut., 3 aut.); Department of Neurology, University of Duisburg-Essen/Essen/Allemagne (2 aut., 4 aut., 7 aut., 9 aut.); Institute of Human Movement Sciences and Sport ETH Zürich/Zürich/Suisse (3 aut.); Department of Neurosurgery, University of Duisburg-Essen/Essen/Allemagne (5 aut.); Department of Neuroradiology, University of Duisburg-Essen/Essen/Allemagne (6 aut.); Department of Neuroradiology, UKGM, Justus-Liebig University/Giessen/Allemagne (6 aut.); Department of Neurology, Briiderkrankenhaus/Trier/Allemagne (8 aut.) |
DT : | Publication en série; Niveau analytique |
SO : | Stroke : (1970); ISSN 0039-2499; Coden SJCCA7; Etats-Unis; Da. 2010; Vol. 41; No. 10; Pp. 2191-2200; Bibl. 37 ref. |
LA : | Anglais |
EA : | 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. |
CC : | 002B17C; 002B17A03 |
FD : | Accident cérébrovasculaire; Ataxie; Pathologie du système nerveux; Pathologie cérébrovasculaire; Membre supérieur; Cervelet; Cartographie; Cinématique; Encéphale; Homme |
FG : | Pathologie de l'appareil circulatoire; Pathologie de l'encéphale; Pathologie du système nerveux central; Pathologie des vaisseaux sanguins; Trouble neurologique |
ED : | Stroke; Ataxia; Nervous system diseases; Cerebrovascular disease; Upper limb; Cerebellum; Cartography; Kinematics; Encephalon; Human |
EG : | Cardiovascular disease; Cerebral disorder; Central nervous system disease; Vascular disease; Neurological disorder |
SD : | Accidente cerebrovascular; Ataxia; Sistema nervioso patología; Vaso sanguíneo encéfalo patología; Miembro superior; Cerebelo; Cartografía; Cinemática; Encéfalo; Hombre |
LO : | INIST-4004.354000192450920100 |
ID : | 10-0476192 |
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Pascal:10-0476192Le document en format XML
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<author><name sortKey="Maschke, Matthias" sort="Maschke, Matthias" uniqKey="Maschke M" first="Matthias" last="Maschke">Matthias Maschke</name>
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<author><name sortKey="Frings, Markus" sort="Frings, Markus" uniqKey="Frings M" first="Markus" last="Frings">Markus Frings</name>
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<series><title level="j" type="main">Stroke : (1970)</title>
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<seriesStmt><title level="j" type="main">Stroke : (1970)</title>
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<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>
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<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>
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<sZ>1 aut.</sZ>
<sZ>3 aut.</sZ>
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<fA14 i1="02"><s1>Department of Neurology, University of Duisburg-Essen</s1>
<s2>Essen</s2>
<s3>DEU</s3>
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<sZ>4 aut.</sZ>
<sZ>7 aut.</sZ>
<sZ>9 aut.</sZ>
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<fA14 i1="03"><s1>Institute of Human Movement Sciences and Sport ETH Zürich</s1>
<s2>Zürich</s2>
<s3>CHE</s3>
<sZ>3 aut.</sZ>
</fA14>
<fA14 i1="04"><s1>Department of Neurosurgery, University of Duisburg-Essen</s1>
<s2>Essen</s2>
<s3>DEU</s3>
<sZ>5 aut.</sZ>
</fA14>
<fA14 i1="05"><s1>Department of Neuroradiology, University of Duisburg-Essen</s1>
<s2>Essen</s2>
<s3>DEU</s3>
<sZ>6 aut.</sZ>
</fA14>
<fA14 i1="06"><s1>Department of Neuroradiology, UKGM, Justus-Liebig University</s1>
<s2>Giessen</s2>
<s3>DEU</s3>
<sZ>6 aut.</sZ>
</fA14>
<fA14 i1="07"><s1>Department of Neurology, Briiderkrankenhaus</s1>
<s2>Trier</s2>
<s3>DEU</s3>
<sZ>8 aut.</sZ>
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<fC01 i1="01" l="ENG"><s0>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.</s0>
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</fC02>
<fC02 i1="02" i2="X"><s0>002B17A03</s0>
</fC02>
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<s5>01</s5>
</fC03>
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<s5>01</s5>
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<s5>01</s5>
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<s5>02</s5>
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<s5>02</s5>
</fC03>
<fC03 i1="02" i2="X" l="SPA"><s0>Ataxia</s0>
<s5>02</s5>
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<s5>03</s5>
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<s5>03</s5>
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<s5>03</s5>
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<s5>04</s5>
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<s5>04</s5>
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<s5>04</s5>
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<s5>09</s5>
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<s5>09</s5>
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<s5>09</s5>
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<s5>10</s5>
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<s5>10</s5>
</fC03>
<fC03 i1="06" i2="X" l="SPA"><s0>Cerebelo</s0>
<s5>10</s5>
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<s5>11</s5>
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<s5>11</s5>
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<s5>11</s5>
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<fC03 i1="08" i2="X" l="FRE"><s0>Cinématique</s0>
<s5>12</s5>
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<fC03 i1="08" i2="X" l="ENG"><s0>Kinematics</s0>
<s5>12</s5>
</fC03>
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<s5>12</s5>
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<s5>13</s5>
</fC03>
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<s5>13</s5>
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<s5>13</s5>
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<s5>14</s5>
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<s5>14</s5>
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<s5>14</s5>
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<s5>37</s5>
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<s5>37</s5>
</fC07>
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<s5>37</s5>
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<s5>38</s5>
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<s5>38</s5>
</fC07>
<fC07 i1="02" i2="X" l="SPA"><s0>Encéfalo patología</s0>
<s5>38</s5>
</fC07>
<fC07 i1="03" i2="X" l="FRE"><s0>Pathologie du système nerveux central</s0>
<s5>39</s5>
</fC07>
<fC07 i1="03" i2="X" l="ENG"><s0>Central nervous system disease</s0>
<s5>39</s5>
</fC07>
<fC07 i1="03" i2="X" l="SPA"><s0>Sistema nervosio central patología</s0>
<s5>39</s5>
</fC07>
<fC07 i1="04" i2="X" l="FRE"><s0>Pathologie des vaisseaux sanguins</s0>
<s5>41</s5>
</fC07>
<fC07 i1="04" i2="X" l="ENG"><s0>Vascular disease</s0>
<s5>41</s5>
</fC07>
<fC07 i1="04" i2="X" l="SPA"><s0>Vaso sanguíneo patología</s0>
<s5>41</s5>
</fC07>
<fC07 i1="05" i2="X" l="FRE"><s0>Trouble neurologique</s0>
<s5>42</s5>
</fC07>
<fC07 i1="05" i2="X" l="ENG"><s0>Neurological disorder</s0>
<s5>42</s5>
</fC07>
<fC07 i1="05" i2="X" l="SPA"><s0>Trastorno neurológico</s0>
<s5>42</s5>
</fC07>
<fN21><s1>312</s1>
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<fN82><s1>OTO</s1>
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<server><NO>PASCAL 10-0476192 INIST</NO>
<ET>Recovery of Upper Limb Function After Cerebellar Stroke Lesion Symptom Mapping and Arm Kinematics</ET>
<AU>KONCZAK (Jürgen); PIERSCIANEK (Daniela); HIRSIGER (Sarah); BULTMANN (Uta); SCHOCH (Beate); GIZEWSKI (Elke R.); TIMMANN (Dagmar); MASCHKE (Matthias); FRINGS (Markus)</AU>
<AF>Human Sensorimotor Control Laboratory, University of Minnesota/Minneapolis, Mn/Etats-Unis (1 aut., 3 aut.); Department of Neurology, University of Duisburg-Essen/Essen/Allemagne (2 aut., 4 aut., 7 aut., 9 aut.); Institute of Human Movement Sciences and Sport ETH Zürich/Zürich/Suisse (3 aut.); Department of Neurosurgery, University of Duisburg-Essen/Essen/Allemagne (5 aut.); Department of Neuroradiology, University of Duisburg-Essen/Essen/Allemagne (6 aut.); Department of Neuroradiology, UKGM, Justus-Liebig University/Giessen/Allemagne (6 aut.); Department of Neurology, Briiderkrankenhaus/Trier/Allemagne (8 aut.)</AF>
<DT>Publication en série; Niveau analytique</DT>
<SO>Stroke : (1970); ISSN 0039-2499; Coden SJCCA7; Etats-Unis; Da. 2010; Vol. 41; No. 10; Pp. 2191-2200; Bibl. 37 ref.</SO>
<LA>Anglais</LA>
<EA>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.</EA>
<CC>002B17C; 002B17A03</CC>
<FD>Accident cérébrovasculaire; Ataxie; Pathologie du système nerveux; Pathologie cérébrovasculaire; Membre supérieur; Cervelet; Cartographie; Cinématique; Encéphale; Homme</FD>
<FG>Pathologie de l'appareil circulatoire; Pathologie de l'encéphale; Pathologie du système nerveux central; Pathologie des vaisseaux sanguins; Trouble neurologique</FG>
<ED>Stroke; Ataxia; Nervous system diseases; Cerebrovascular disease; Upper limb; Cerebellum; Cartography; Kinematics; Encephalon; Human</ED>
<EG>Cardiovascular disease; Cerebral disorder; Central nervous system disease; Vascular disease; Neurological disorder</EG>
<SD>Accidente cerebrovascular; Ataxia; Sistema nervioso patología; Vaso sanguíneo encéfalo patología; Miembro superior; Cerebelo; Cartografía; Cinemática; Encéfalo; Hombre</SD>
<LO>INIST-4004.354000192450920100</LO>
<ID>10-0476192</ID>
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