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Perilesional reorganization of motor function in stroke patients

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Neural Regeneration Research 2010年第21期5卷 1668-1672页

作者： sung ho jang Department of Physical Medicine and Rehabilitation College of Medicine Yeungnam University

Perilesional reorganization is an important recovery mechanism for stroke patients because it yields good motor outcomes. however, perilesional reorganization remains poorly understood. The scientific basis for stroke rehabilitation can be established when detailed mechanisms of recovery are clarified. In addition, studies at the subcortical level remain in the early stages. Therefore, the present study suggested that additional investigations should focus on perilesional reorganization at the subcortical level, identifying the critical period for this mechanism and determining treatment strategies and modalities to facilitate development. The present study reviews literature focused on perilesional reorganization in stroke patients with regard to demonstration, clinical characteristics, and rehabilitative aspects, as well as previous studies of perilesional reorganization at cortical and subcortical levels.

关键词： stroke motor recovery functional MRI diffusion tensor imaging brain plasticity reorganization

Isolated corticospinal tract in a patient with intracerebral hemorrhage A diffusion tensor tractography and transcranial magnetic stimulation study

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Neural Regeneration Research 2011年第7期6卷 558-560页

作者： sung ho jang Department of Physical Medicine and Rehabilitation College of Medicine Yeungnam University

Diffusion tensor tractography allows visualization of the corticospinal tract （CST） in three dimensions. Transcranial magnetic stimulation offers a unique advantage in that it can distinguish between the corticospinal tract and the non-CST by analyzing the characteristics of a motor-evoked potential. A 15 year-old female showed right hemiparesis, due to intracerebral hemorrhage in the left corona radiata, and the posterior limb of the internal capsule. Diffusion tensor tractography revealed that the tracts of both hemispheres originated from the precentral gyrus, and descended through the known CST pathway. Specifically, the tract of the affected hemisphere descended through an isolated area in the leukomalactic lesion at the posterior limb level. In addition, the characteristics of the motor-evoked potential obtained from the right hand when stimulating the hot spot of the left motor cortex corresponded to a CST. In conclusion, we report on a patient with intracerebral hemorrhage who showed an isolated CST in a leukomalactic lesion. This result suggests the importance of saving the adjacent area or penumbra around a hematoma after an intracerebral hemorrhage.

关键词： stroke motor recovery corticospinal tract magnetic stimulation diffusion tensor im-aging

Spared integrity of corticospinal tract within a pontine infarct A diffusion tensor tractography study

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Neural Regeneration Research 2010年第20期5卷 1552-1554页

作者： sung ho jang Department of Physical Medicine and Rehabilitation College of Medicine Yeungnam University Daegu 705-717 Republic of Korea

Integrity of the corticospinal tract is mandatory for good recovery of impaired motor function in patients who have suffered a stroke.A 67-year-old left hemiparetic female showed an infarct in the right *** months after onset,motor function of the affected extremities recovered rapidly to a nearly complete *** tensor tractography of both hemispheres showed that the corticospinal tract originated from the primary sensori-motor cortex and descended through the known corticospinal tract *** tract of the affected（right）hemisphere descended through an area within the pontine *** diffusion tensor tractography results suggest that from the onset,the integrity of the corticospinal tract appears to have been spared within the pontine infarct.

关键词： pontine infarct diffusion tensor imaging corticospinal tract stroke motor recovery

Medial reorganization of motor function in corona radiata following middle cerebral artery infarction A case report

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Neural Regeneration Research 2009年第9期4卷 668-671页

作者： sung ho jang Department of Physical Medicine & Rehabilitation Yeungnam University College of Medicine

Peri-lesional reorganization is one of the motor recovery mechanisms following stroke. A 23-year-old female who presented with complete paralysis of the right extremities at the onset of infarct in the left middle cerebral artery territory was included. She slowly recovered some function, and could extend the affected knee with resistance after 9 months. Diffusion tensor tractography, functional MRI, and transcranial magnetic stimulation testing were performed at 7 years after onset. Results showed that diffusion tensor tractography of the affected （left） hemisphere passed through the medial corona radiata at, or around, the wall of the lateral ventricle. The contralateral primary sensorimotor cortex was activated during affected knee movements. The motor-evoked potential, which was obtained from the affected leg, exhibited corticospinal tract characteristics. Results indicated that motor function of the affected leg recovered via the corticospinal tract, which descended through the corona radiata medial to the infarct. The motor function of the affected leg was reorganized to the medial corona radiata following infarct to the middle cerebral artery territory.

关键词： functional magnetic resonance imaging stroke cortical reorganization motor recovery diffusion tensor tractography transcranial maanetic stimulation

Unusual long-term motor recovery in a patient with corona radiata infarct

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Neural Regeneration Research 2010年第17期5卷 1353-1356页

作者： sung ho jang Department of Physical Medicine and Rehabilitation College of MedicineYeungnam UniversityDaegu 705-717Republic of Korea

The majority of motor recovery following stroke occurs within 6 months after *** present study examined a patient with a corona radiata infarct,who exhibited an unusual long-term recovery（24 months after onset）.The patient was a 64-year-old female,who presented with severe paralysis of the left extremities resulting from a corona radiate *** recovery from the weakness progressed slowly over a 24-month period following onset,even at 6-12 months after *** tensor tractography at 2 weeks from onset showed disruption of the corticospinal tract of the affected hemisphere resulting from the ***,at 12 and 24 months after onset,the corticospinal tract was elongated to the cortex level,as shown by diffusion tensor tractography.A 2-week transcranial magnetic stimulation showed no motor-evoked potential for the affected hemisphere,but a motor-evoked potential of the corticospinal tract was observed at12 and 24 *** results suggest that motor function recovery in cerebral infarct patients can occur at least up to 24 months after stroke onset.

关键词： stroke motor recovery cerebral infarct diffusion tensor tractography transcranial magnetic stimulation diffusion tensor imaging

Recovery of gait and injured corticoreticulospinal tracts in a patient with diffuse axonal injury

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Neural Regeneration Research 2021年第5期16卷 924-925页

作者： sung ho jang You sung Seo Department of Physical Medicine and Rehabilitation College of MedicineYeungnam UniversityDaeguRepublic of Korea

Diffuse axonal injury(DAI)is defined as the presence of microscopic axonal damage in the white matter of the brain produced by mechanical forces and is characterized histologically by widespread damage to axons(Maxwell et al.,1997).Diffusion tensor imaging(DTI)allows evaluation of the integrity of the white matter of brain to be determined by virtue of its ability to image water diffusion characteristics(Basser et al.,1994).

关键词： axonal al. damage

Diffusion tensor tractography characteristics of axonal injury in concussion/mild traumatic brain injury

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Neural Regeneration Research 2022年第5期17卷 978-982页

作者： sung ho jang You sung Seo Department of Physical Medicine and Rehabilitation College of MedicineYeungnam UniversityDaeguRepublic of Korea

The main advantage of diffusion tensor tractography is that it allows the entire neural tract to be *** addition,configurational analysis of reconstructed neural tracts can indicate abnormalities such as tearing,narrowing,or discontinuations,which have been used to identify axonal injury of neural tracts in concussion *** review focuses on the characteristic features of axonal injury in concussion or mild traumatic brain injury(m TBI)patients through the use of diffusion tensor *** injury in concussion(m TBI)patients is characterized by their occurrence in long neural tracts and multiple injuries,and these characteristics are common in patients with diffuse axonal injury and in concussion(m TBI)patients with axonal ***,the discontinuation of the corticospinal tract is mostly observed in diffuse axonal injury,and partial tearing and narrowing in the subcortical white matter are frequently observed in concussion(m TBI)patients with axonal *** difference appears to be attributed to the observation that axonal injury in concussion(m TBI)patients is the result of weaker forces than those producing diffuse axonal *** addition,regarding the fornix,in diffuse axonal injury,discontinuation of the fornical crus has been frequently reported,but in concussion(m TBI)patients,many collateral branches form in the fornix in addition to these findings in many case *** is presumed that the impact on the brain in TBI is relatively weaker than that in diffuse axonal injury,and that the formation of collateral branches occurs during the fornix recovery *** the occurrence of axonal injury in multiple areas of the brain is an important feature of diffuse axonal injury,case studies in concussion(m TBI)have shown that axonal injury occurs in multiple neural *** axonal injury lesions in m TBI patients may persist for approximately 10 years after injury onset,the characteristics of axonal injury in co

关键词： axonal injury brain injury concussion diffusion tensor imaging diffusion tensor tractography mild traumatic brain injury neural tract

Recovery of a degenerated corticospinal tract after injury in a patient with intracerebral hemorrhage:confirmed by diffusion tensor tractography imaging

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Neural Regeneration Research 2015年第5期10卷 829-831页

作者： You sung Seo sung ho jang Department of Physical Medicine and Rehabilitation College of MedicineYeungnam University

The corticospinal tract （CST） is a major neuronal tract of motor function in the human brain （York, 1987; Davidoff, 1990; jang, 2014）. Recovery of an injured CST is one of the motor recovery mechanisms in stroke patients （Hendricks et al., 2003; jang et al., 2006, 2007; Swayne et al., 2008; Kwon et al., 2011, 2013; Kwon and jang, 2012; Yeo and jang, 2013; Rong et al., 2014）. Diffusion tensor tractography （DTT）, derived from diffusion tensor imaging （DTI）, and transcra- nial magnetic stimulation （TMS） have been widely used in demonstrating the recovery of an injured CST （Hendricks et al., 2003; jang et al., 2006, 2007; Swayne et al., 2008; Pannek et al., 2009; Kwon et al., 2011, 2013; Kwon and jang, 2012; Yeo and jang, 2013; Rong et al., 2014）. DTT has the advan- tage of enabling visualization of the architecture and integ- rity of the CST at the subcortical level in three dimensions （Mori et al., 1999; Kunimatsu et al., 2004）.

关键词： Recovery of a degenerated corticospinal tract after injury in a patient with intracerebral hemorrhage CST DTT ICH TMS

Delayed neurological deterioration following head trauma

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Neural Regeneration Research 2010年第23期5卷 1829-1831页

作者： sung ho jang Department of Physical Medicine and Rehabilitation College of MedicineYeungnam University

We report a patient who presented with neurological deterioration 26 days after a motor vehicle accident. A 25-year-old man crashed a car onto farmland from a height of approximately 3 meters. Neurological deterioration including ataxia and visual disturbance became apparent 26 days after the accident. Brain magnetic resonance imaging did not reveal any abnormality, but brain single photon emission computed tomography showed mild hypoperfusion in the left frontotemporal lobe. An ophthalmic examination revealed no specific abnormality, but visual-evoked potentials revealed prolonged latencies in both eyes. We propose that this neurological deterioration might have resulted from traumatic axonal injury. As such, future studies should examine preventive strategies against delayed deterioration in patients with head trauma.

关键词： brain injury ataxia axonal injury head trauma