Mechanisms of functional loss and early recovery in stroke
Final Report Abstract
There are patients, who recover very rapidly from a stroke despite persisting lesions, while others don’t. The reasons for this clinical highly important phenomenon are unclear. We used a combined multimodal MRI study to delineate unspecific, ischemia related effects on not infracted brain tissue from systemic effects, i.e. effects restricted to the functionally affected system, i.e. diaschisis. We compared motor and language activation patterns in strokes with either or both systems affected. We did find commonalities and differences between the domains and finally identified target regions (as dorsal premotor cortex) from studies in healthy subjects, which turned out to be selectively and only functionally affected. The date support the notion, that there is diaschisis human stroke, in the motor as well as in the language system. A dissociation of affection by lesions supports the notion that there are different systems in the brain and diaschisis indeed is a temporary, reversible phenomenon. As v. Monakow predicted it seems mainly to affect secondary or tertiary areas, rather than primary cortices and affected regions may be activated from a different domain. The study produces several more questions, which should be investigated in follow-up studies, as this will help for prediction of recovery and allocation to individual treatment regimens.
Publications
- (2008) Cerebellar autoregulation dynamics in humans. J Cereb Blood Flow Metab. 2008 Sep;28(9):1605-12. Epub 2008 May 21
Reinhard M, Waldkircher Z, Timmer J, Weiller C, Hetzel A
- (2008) Ventral and dorsal pathways for language. Proc Natl Acad Sci U S A. 2008 Nov 18;105(46):18035-40. Epub 2008 Nov 12
Saur D, Kreher BW, Schnell S, Kümmerer D, Kellmeyer P, Vry MS, Umarova R, Musso M, Glauche V, Abel S, Huber W, Rijntjes M, Hennig J, Weiller C
- (2009) Please don't underestimate the ventral pathway in language. Trends Cogn Sci. 2009 Sep;13(9):369-70; 370-1. Epub 2009 Aug 27
Weiller C, Musso M, Rijntjes M, Saur D
- (2009) The longitudinal changes of BOLD response and cerebral hemodynamics from acute to subacute stroke. A fMRI and TCD study. BMC Neurosci. 2009 Dec 20;10:151
Altamura C, Reinhard M, Vry MS, Kaller CP, Hamzei F, Vernieri F, Rossini PM, Hetzel A, Weiller C, Saur D
- (2010) Combining functional and anatomical connectivity reveals brain networks for auditory language comprehension. Neuroimage. 2010 Feb 15;49(4):3187-97. Epub 2009 Nov 12
Saur D, Schelter B, Schnell S, Kratochvil D, Küpper H, Kellmeyer P, Kümmerer D, Klöppel S, Glauche V, Lange R, Mader W, Feess D, Timmer J, Weiller C
- (2010) Structural connectivity for visuospatial attention: significance of ventral pathways. Cereb Cortex. 2010 Jan;20(1):121-9. Epub
Umarova RM, Saur D, Schnell S, Kaller CP, Vry MS, Glauche V, Rijntjes M, Hennig J, Kiselev V, Weiller C
- (2011) How the ventral pathway got lost: and what its recovery might mean. Brain Lang. 2011 Jul;118(1-2):29-39. Epub 2011 Mar 22
Weiller C, Bormann T, Saur D, Musso M, Rijntjes M
(See online at https://doi.org/10.1016/j.bandl.2011.01.005) - (2012) Ventral and dorsal fiber systems for imagined and executed movement. Exp Brain Res. 2012 Apr 3. [Epub ahead of print]
Vry MS, Saur D, Rijntjes M, Umarova R, Kellmeyer P, Schnell S, Glauche V, Hamzei F, Weiller C
(See online at https://doi.org/10.1007/s00221-012-3079-7)
