Cargando…

Stroke Lesion Impact on Lower Limb Function

The impact of stroke on motor functioning is analyzed at different levels. ‘Impairment’ denotes the loss of basic characteristics of voluntary movement. ‘Activity limitation’ denotes the loss of normal capacity for independent execution of daily activities. Recovery from impairment is accomplished b...

Descripción completa

Detalles Bibliográficos
Autores principales: Frenkel-Toledo, Silvi, Ofir-Geva, Shay, Mansano, Lihi, Granot, Osnat, Soroker, Nachum
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Frontiers Media S.A. 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7882502/
https://www.ncbi.nlm.nih.gov/pubmed/33597852
http://dx.doi.org/10.3389/fnhum.2021.592975
_version_ 1783651061229158400
author Frenkel-Toledo, Silvi
Ofir-Geva, Shay
Mansano, Lihi
Granot, Osnat
Soroker, Nachum
author_facet Frenkel-Toledo, Silvi
Ofir-Geva, Shay
Mansano, Lihi
Granot, Osnat
Soroker, Nachum
author_sort Frenkel-Toledo, Silvi
collection PubMed
description The impact of stroke on motor functioning is analyzed at different levels. ‘Impairment’ denotes the loss of basic characteristics of voluntary movement. ‘Activity limitation’ denotes the loss of normal capacity for independent execution of daily activities. Recovery from impairment is accomplished by ‘restitution’ and recovery from activity limitation is accomplished by the combined effect of ‘restitution’ and ‘compensation.’ We aimed to unravel the long-term effects of variation in lesion topography on motor impairment of the hemiparetic lower limb (HLL), and gait capacity as a measure of related activity limitation. Gait was assessed by the 3 m walk test (3MWT) in 67 first-event chronic stroke patients, at their homes. Enduring impairment of the HLL was assessed by the Fugl–Meyer Lower Extremity (FMA-LE) test. The impact of variation in lesion topography on HLL impairment and on walking was analyzed separately for left and right hemispheric damage (LHD, RHD) by voxel-based lesion-symptom mapping (VLSM). In the LHD group, HLL impairment tended to be affected by damage to the posterior limb of the internal capsule (PLIC). Walking capacity tended to be affected by a larger array of structures: PLIC and corona radiata, external capsule and caudate nucleus. In the RHD group, both HLL impairment and walking capacity were sensitive to damage in a much larger number of brain voxels. HLL impairment was affected by damage to the corona radiata, superior longitudinal fasciculus and insula. Walking was affected by damage to the same areas, plus the internal and external capsules, putamen, thalamus and parts of the perisylvian cortex. In both groups, voxel clusters have been found where damage affected FMA-LE and also 3MWT, along with voxels where damage affected only one of the measures (mainly 3MWT). In stroke, enduring ‘activity limitation’ is affected by damage to a much larger array of brain structures and voxels within specific structures, compared to enduring ‘impairment.’ Differences between the effects of left and right hemisphere damage are likely to reflect variation in motor-network organization and post-stroke re-organization related to hemispheric dominance. Further studies with larger sample size are required for the validation of these results.
format Online
Article
Text
id pubmed-7882502
institution National Center for Biotechnology Information
language English
publishDate 2021
publisher Frontiers Media S.A.
record_format MEDLINE/PubMed
spelling pubmed-78825022021-02-16 Stroke Lesion Impact on Lower Limb Function Frenkel-Toledo, Silvi Ofir-Geva, Shay Mansano, Lihi Granot, Osnat Soroker, Nachum Front Hum Neurosci Neuroscience The impact of stroke on motor functioning is analyzed at different levels. ‘Impairment’ denotes the loss of basic characteristics of voluntary movement. ‘Activity limitation’ denotes the loss of normal capacity for independent execution of daily activities. Recovery from impairment is accomplished by ‘restitution’ and recovery from activity limitation is accomplished by the combined effect of ‘restitution’ and ‘compensation.’ We aimed to unravel the long-term effects of variation in lesion topography on motor impairment of the hemiparetic lower limb (HLL), and gait capacity as a measure of related activity limitation. Gait was assessed by the 3 m walk test (3MWT) in 67 first-event chronic stroke patients, at their homes. Enduring impairment of the HLL was assessed by the Fugl–Meyer Lower Extremity (FMA-LE) test. The impact of variation in lesion topography on HLL impairment and on walking was analyzed separately for left and right hemispheric damage (LHD, RHD) by voxel-based lesion-symptom mapping (VLSM). In the LHD group, HLL impairment tended to be affected by damage to the posterior limb of the internal capsule (PLIC). Walking capacity tended to be affected by a larger array of structures: PLIC and corona radiata, external capsule and caudate nucleus. In the RHD group, both HLL impairment and walking capacity were sensitive to damage in a much larger number of brain voxels. HLL impairment was affected by damage to the corona radiata, superior longitudinal fasciculus and insula. Walking was affected by damage to the same areas, plus the internal and external capsules, putamen, thalamus and parts of the perisylvian cortex. In both groups, voxel clusters have been found where damage affected FMA-LE and also 3MWT, along with voxels where damage affected only one of the measures (mainly 3MWT). In stroke, enduring ‘activity limitation’ is affected by damage to a much larger array of brain structures and voxels within specific structures, compared to enduring ‘impairment.’ Differences between the effects of left and right hemisphere damage are likely to reflect variation in motor-network organization and post-stroke re-organization related to hemispheric dominance. Further studies with larger sample size are required for the validation of these results. Frontiers Media S.A. 2021-02-01 /pmc/articles/PMC7882502/ /pubmed/33597852 http://dx.doi.org/10.3389/fnhum.2021.592975 Text en Copyright © 2021 Frenkel-Toledo, Ofir-Geva, Mansano, Granot and Soroker. http://creativecommons.org/licenses/by/4.0/ This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
spellingShingle Neuroscience
Frenkel-Toledo, Silvi
Ofir-Geva, Shay
Mansano, Lihi
Granot, Osnat
Soroker, Nachum
Stroke Lesion Impact on Lower Limb Function
title Stroke Lesion Impact on Lower Limb Function
title_full Stroke Lesion Impact on Lower Limb Function
title_fullStr Stroke Lesion Impact on Lower Limb Function
title_full_unstemmed Stroke Lesion Impact on Lower Limb Function
title_short Stroke Lesion Impact on Lower Limb Function
title_sort stroke lesion impact on lower limb function
topic Neuroscience
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7882502/
https://www.ncbi.nlm.nih.gov/pubmed/33597852
http://dx.doi.org/10.3389/fnhum.2021.592975
work_keys_str_mv AT frenkeltoledosilvi strokelesionimpactonlowerlimbfunction
AT ofirgevashay strokelesionimpactonlowerlimbfunction
AT mansanolihi strokelesionimpactonlowerlimbfunction
AT granotosnat strokelesionimpactonlowerlimbfunction
AT sorokernachum strokelesionimpactonlowerlimbfunction