Interhemispheric Functional Connectivity in the Primary Motor Cortex Assessed by Resting-State Functional Magnetic Resonance Imaging Aids Long-Term Recovery Prediction among Subacute Stroke Patients with Severe Hand Weakness

• Main Authors: Yu-Sun Min, Jang Woo Park, Eunhee Park, Ae-Ryoung Kim, Hyunsil Cha, Dae-Won Gwak, Seung-Hwan Jung, Yongmin Chang, Tae-Du Jung
• Format: Article
• Language: English
• Published: MDPI AG 2020-04-01
• Series: Journal of Clinical Medicine
• Subjects: functional magnetic resonance imaging; neuronal plasticity; recovery of function; stroke; motor cortex
• Online Access: https://www.mdpi.com/2077-0383/9/4/975

This study aimed to evaluate the usefulness of interhemispheric functional connectivity (FC) as a predictor of motor recovery in severe hand impairment and to determine the cutoff FC level as a clinically useful parameter. Patients with stroke (<i>n</i> = 22; age, 59.9 ± 13.7 years) who presented with unilateral severe upper-limb paresis and were confirmed to elicit no motor-evoked potential responses were selected. FC was measured using resting-state functional magnetic resonance imaging (rsfMRI) scans at 1 month from stroke onset. The good recovery group showed a higher FC value than the poor recovery group (<i>p</i> = 0.034). In contrast, there was no statistical difference in FC value between the good recovery and healthy control groups (<i>p</i> = 0.182). Additionally, the healthy control group showed a higher FC value than that shown by the poor recovery group (<i>p</i> = 0.0002). Good and poor recovery were determined based on Brunnstrom stage of upper-limb function at 6 months as the standard, and receiver operating characteristic curve indicated that a cutoff score of 0.013 had the greatest prognostic ability. In conclusion, interhemispheric FC measurement using rsfMRI scans may provide useful clinical information for predicting hand motor recovery during stroke rehabilitation.