Functional lateralization in cingulate cortex predicts motor recovery after basal ganglia stroke

Area of Science:

• Neuroscience
• Neurology
• Rehabilitation Medicine

Background:

• The basal ganglia (BG) are crucial for complex motor control, including planning and execution.
• Understanding the effects of BG lesions on motor control after stroke is essential for effective rehabilitation.

Purpose of the Study:

• To investigate the longitudinal neuroimaging changes in stroke patients with basal ganglia lesions.
• To explore the relationship between brain activation patterns, cerebellar (CB) and cingulate cortex lateralization, and motor recovery (Fugl-Meyer Index - FMI).

Main Methods:

• A longitudinal neuroimaging study was conducted on stroke patients with BG lesions at three recovery stages (Session 1: <2 weeks, Session 2: 1-3 months, Session 3: >3 months).
• Functional brain activation and lateralization indices for the cerebellum and cingulate cortex were analyzed.
• Correlation analyses were performed between brain activation patterns and the Fugl-Meyer Index (FMI).

Main Results:

• Patients exhibited a shift in brain activation from bilateral hemispheres in early stages to the ipsilesional cortex in later stages, indicating compensatory mechanisms.
• Cerebellar lateralization for the affected hand task in Session 2 correlated with the concurrent FMI.
• Cingulate cortex lateralization in Session 2 significantly predicted subsequent FMI changes, serving as a prognostic marker for motor recovery.

Conclusions:

• The findings confirm significant interactions between the basal ganglia and cerebellum during post-stroke motor recovery.
• Dominance of activation in the contralateral cingulate cortex is associated with improved motor outcomes, suggesting the role of ipsilesional attention modulation in early recovery after BG stroke.