Enhanced interhemispheric functional connectivity compensates for anatomical connection damages in subcortical stroke

Stroke. 2015 Apr;46(4):1045-51. doi: 10.1161/STROKEAHA.114.007044. Epub 2015 Feb 26.

Abstract

Background and purpose: Motor recovery after stroke has been shown to be correlated with both the fractional anisotropy (FA) of the affected corticospinal tract (CST) and the interhemispheric resting-state functional connectivity (rsFC) of the primary motor cortex (M1). However, the role of the restoration or enhancement of the M1-M1 rsFC in motor recovery remains largely unknown. We aimed to clarify this issue by investigating the correlations between the M1-M1 rsFC and the integrity of the M1-M1 anatomic connection and the affected CST in chronic subcortical stroke patients with good motor outcomes.

Methods: Twenty patients and 16 healthy controls underwent multimodal magnetic resonance imaging examinations. Diffusion tensor imaging was used to reconstruct the M1-M1 anatomic connection and bilateral CSTs. White matter integrity of these tracts was assessed using FA. Resting-state functional magnetic resonance imaging was used to calculate M1-M1 rsFC. Group differences in these measures were compared. Correlations between M1-M1 rsFC and FA of the M1-M1 anatomic connection and the affected CST were analyzed in patients with stroke.

Results: Compared with healthy controls, patients with stroke exhibited significantly reduced FA in the affected CST and the M1-M1 anatomic connection and a significantly increased M1-M1 rsFC. The FA values of the affected CST were positively correlated with the M1-M1 anatomic connection, and these FA values were negatively correlated with the M1-M1 rsFC in these patients.

Conclusions: Our findings suggest that the M1-M1 anatomic connection impairment is secondary to CST damage, and the M1-M1 rsFC enhancement may reflect compensatory or reactive neural plasticity in stroke patients with CST impairment.

Keywords: cerebral infarction; diffusion tensor imaging; functional neuroimaging; magnetic resonance imaging; motor cortex; neuronal plasticity.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Aged
  • Anisotropy
  • Connectome*
  • Diffusion Tensor Imaging
  • Female
  • Humans
  • Magnetic Resonance Imaging / methods*
  • Male
  • Middle Aged
  • Motor Cortex / pathology
  • Motor Cortex / physiopathology*
  • Nerve Net / pathology
  • Nerve Net / physiopathology*
  • Neuronal Plasticity / physiology
  • Pyramidal Tracts / pathology
  • Pyramidal Tracts / physiopathology*
  • Recovery of Function / physiology*
  • Stroke / pathology
  • Stroke / physiopathology*