Neuronal-glial alterations in non-primary motor areas in chronic subcortical stroke

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• 作者：Carmen M. Cirstea^a ; ^c ; ^d ; ^{ccirstea@kumc.edu} ; Randolph J. Nudo^b ; ^e ; Sorin C. Craciunas^a ; ¹ ; Elena A. Popescu^a ; In-Young Choi^a ; ^d ; Phil Lee^a ; ^e ; Hung-Wen Yeh^f ; Cary R. Savage^g ; William M. Brooks^a ; ^d
• 关键词：NAA ; N-acetylaspartate ; mI ; myo-inositol ; Glx ; glutamate  ; +  ; glutamine ; PMd ; dorsal premotor cortex ; SMA ; supplementary motor area ; M1 ; primary motor cortex ; FMUE ; Fugl-Meyer Upper Extremity test
• 刊名：Brain Research
• 出版年：2012
• 期刊代码：8_00068993
• 类别：neu
• 出版时间：29 June, 2012
• 卷：1463
• 期：Complete
• 页码：75-84
• 文件大小：612 K

摘要

Whether functional changes of the non-primary motor areas, e.g., dorsal premotor (PMd) and supplementary motor (SMA) areas, after stroke, reflect reorganization phenomena or recruitment of a pre-existing motor network remains to be clarified. We hypothesized that cellular changes in these areas would be consistent with their involvement in post-stroke reorganization. Specifically, we expected that neuronal and glial compartments would be altered in radiologically normal-appearing, i.e., spared, PMd and SMA in patients with arm paresis. Twenty survivors of a single ischemic subcortical stroke and 16 age-matched healthy controls were included. At more than six months after stroke, metabolites related to neuronal and glial compartments: N-acetylaspartate, myo-inositol, and glutamate/glutamine, were quantified by proton magnetic resonance spectroscopy in PMd and SMA in both injured (ipsilesional) and un-injured (contralesional) hemispheres. Correlations between metabolites were also calculated. Finally, relationships between metabolite concentrations and arm motor impairment (total and proximal Fugl-Meyer Upper Extremity, FMUE, scores) were analyzed. Compared to controls, stroke survivors showed significantly higher ipsilesional PMd myo-inositol and lower SMA N-acetylaspartate. Significantly lower metabolite correlations were found between ipsilesional and contralesional SMA. Ipsilesional N-acetylaspartate was significantly related to proximal FMUE scores. This study provides evidence of abnormalities in metabolites, specific to neuronal and glial compartments, across spared non-primary motor areas. Ipsilesional alterations were related to proximal arm motor impairment. Our results suggest the involvement of these areas in post-stroke reorganization.