A longitudinal study of brain activation during stroke recovery using BOLD-fMRI

Stroke recovery involves a battery of plastic changes in the brain. Blood oxygen level dependent (BOLD) functional magnetic resonance imaging (fMRI) provides brain activation information with exquisite spatial resolution as a powerful tool for investigating changes in brain plasticity. In this paper, we performed a longitudinal study examining plasticity of functional activation by BOLD-fMRI following stroke. Data were collected from 11 patients with corticospinal tract (CST) damage at three stages of recovery, i.e., acute stage (<;2wks), early stage (1mon-3mons) and chronic stage (>3mons) post stroke. The evolution of cortical activations for both affected and unaffected hand motion tasks were studied. Quantitative activation measurements including the effective size and sum of t values were calculated and the correlations with patient Fugl-Meyer index were analyzed across all stages. Stroke patients showed a shift from bilateral activation in acute and early stage to the ipsilesional activation in chronic stage when performing a movement task with the affected hand, which suggests a compensation effect from the contralesional hemisphere during the recovery process. The correlation analysis showed a significantly negative correlation with cingulate cortex activity at early stage from both quantitative activation measurements, implying the special role of cingulate cortex in stroke recovery. Further investigations are in need to improve the understanding of brain plasticity in stroke patients.