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Time-dependent functional role of the contralesional motor cortex after stroke

Volz, LJ; Vollmer, M; Michely, J; Fink, GR; Rothwell, JC; Grefkes, C; (2017) Time-dependent functional role of the contralesional motor cortex after stroke. NeuroImage: Clinical , 16 pp. 165-174. 10.1016/j.nicl.2017.07.024. Green open access

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Abstract

After stroke, movements of the paretic hand rely on altered motor network dynamics typically including additional activation of the contralesional primary motor cortex (M1). The functional implications of contralesional M1 recruitment to date remain a matter of debate. We here assessed the role of contralesional M1 in 12 patients recovering from a first-ever stroke using online transcranial magnetic stimulation (TMS): Short bursts of TMS were administered over contralesional M1 or a control site (occipital vertex) while patients performed different motor tasks with their stroke-affected hand. In the early subacute phase (1-2 weeks post-stroke), we observed significant improvements in maximum finger tapping frequency when interfering with contralesional M1, while maximum grip strength and speeded movement initiation remained unaffected. After > 3 months of motor recovery, disruption of contralesional M1 activity did not interfere with performance in any of the three tasks, similar to what we observed in healthy controls. In patients with mild to moderate motor deficits, contralesional M1 has a task- and time-specific negative influence on motor performance of the stroke-affected hand. Our results help to explain previous contradicting findings on the role of contralesional M1 in recovery of function.

Type: Article
Title: Time-dependent functional role of the contralesional motor cortex after stroke
Location: Netherlands
Open access status: An open access version is available from UCL Discovery
DOI: 10.1016/j.nicl.2017.07.024
Publisher version: https://doi.org/10.1016/j.nicl.2017.07.024
Language: English
Additional information: Copyright © 2017 The Authors. Published by Elsevier Inc. This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/BY-NC-ND/4.0/).
Keywords: Motor reorganization; Cortical plasticity; Brain stimulation; Motor control
UCL classification: UCL > Provost and Vice Provost Offices
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Brain Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Brain Sciences > UCL Queen Square Institute of Neurology
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Brain Sciences > UCL Queen Square Institute of Neurology > Clinical and Movement Neurosciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Brain Sciences > UCL Queen Square Institute of Neurology > Imaging Neuroscience
URI: http://discovery.ucl.ac.uk/id/eprint/1570109
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