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Recruitment of contralesional motor cortex in stroke patients with recovery of hand function

From the Neurological Therapeutic Center (Drs. Bütefisch, Kleiser, Körber, Müller, and Hömberg), Department of Neurology (Drs. Bütefisch, Kleiser, and Seitz), Institute of Diagnostic Radiology (Dr. Wittsack), and Biomedizinisches Forschungszentrum (Dr. Seitz), Heinrich-Heine University Düsseldorf, Düsseldorf, Germany.

Address correspondence and reprint requests to Dr. Cathrin M. Bütefisch, Neurologic Therapeutic Center, Heinrich-Heine University Düsseldorf, Hohensandweg 37, 40591 Düsseldorf, Germany; e-mail: cathrin.buetefisch{at}uni-duesseldorf.de

In neuroimaging studies of stroke patients, coactivation may account for increased recruitment of bilateral motor areas when moving the affected limb. Here we studied eight patients after stroke with fMRI and simultaneous EMG. Bilateral recruitment of premotor and primary motor cortices was evident in five patients with strictly unilateral performance per EMG. Because patients had excellent motor recovery, this increased recruitment suggests an adaptive response to the infarct.

Additional material related to this article can be found on the Neurology Web site. Go to www.neurology.org and scroll down the Table of Contents for the March 22 issue to find the title link for this article.

Supported by grant 01GI9906 (Kompetenznetz Schlaganfall) and Brain Imaging Center West from the Deutsches Bundesministerium für Bildung und Forschung and by a grant from the Ministerium für Schule, Wissenschaft und Forschung des Landes Nordrhein-Westfalen.

Received September 1, 2004. Accepted in final form November 29, 2004.

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