뇌경색 환자의 병변 위치에 따른 운동신경기능 회복기전

Objective: The aim of this study was to elucidate how the location of cerebral infarct influences cortical recovery pattern in hemiparetic stroke patients. Method: Forty-three chronic stroke patients and 21 control subjects were recruited for the study. The patients were classified into 4 groups according to infarct locations: cortex (CO), corona radiata (CR), posterior limb of the internal capsule (PL), and brainstem (BS). Functional MRI was performed using the blood oxygen level-dependent technique at 1.5 T with the motor task of hand grasp-release movements. Results: The activation pattern of the primary sensori-motor cortex (SM1) was found to be significantly influenced by the lesion locations, but that of the secondary motor area was not (Pearson's chi-square test, p＜0.05). The ‘contralateral' SM1 activation was the major response in the control group (85.7%) and in the BS group (75.0%). On the other hand, the major activation pattern was ‘peri-lesional' in the CO group (peri-lesional 57.1%, peri-lesional and ipsilateral 42.9%), ‘bilateral activation' in the CR (85.7%) and the PL group (100.0%). Conclusion: Our results suggested that motor recovery mechanisms could be different according to location of cerebral infarct. KCI Citation Count: 0