Case Report: True Motor Recovery of Upper Limb Beyond 5 Years Post-stroke
Carine Ciceron1,2, Dominique Sappey-Marinier3,4, Paola Riffo1
1Service de Médecine Physique et Réadaptation, Plateforme Mouvement et Handicap, Hôpital Henry Gabrielle, Hospices Civils de Lyon, Pierre-Bénite, France.
Frontiers in Neurology
|March 7, 2022
Summary
Remarkable late motor recovery in the upper limb occurred 2-12 years after a stroke. This genuine neurological recovery, involving brain plasticity, offers new hope for stroke patients.
Area of Science:
- Neuroscience
- Neurology
- Rehabilitation Medicine
Background:
- Most motor recovery after stroke occurs within 3 months.
- Late recovery is rare and poorly understood.
- Understanding late recovery mechanisms is crucial for improving patient outcomes.
Observation:
- A patient experienced significant late recovery of right upper-limb motor function 2-12 years after a left middle cerebral artery stroke.
- Recovery progressed proximally to distally, including independent finger movements.
- Clinical and quantitative movement analyses indicated true neurological recovery, not compensation.
Findings:
- Diffusion tensor imaging revealed localized corticospinal tract (CST) alteration without downstream propagation.
- Functional MRI showed activation in contralateral sensorimotor areas and bilateral motor networks during hand movements.
- Transcranial magnetic stimulation indicated normal motor evoked potentials and no ipsilateral pathway activation.
Implications:
- Late upper-limb motor recovery is possible years after stroke.
- Brain plasticity in sensorimotor areas and CST integrity are key to recovery.
- This case provides insights into neuroplasticity mechanisms underlying late motor function restoration.
