Abstract:Objective: To assess the effects of stroke involvement of primary and secondary hemispheric motor systems and corticofugal tracts on ann and hand recovery, Methods: Sixty-one patients participating in an inpatient stroke rehabilitation database, admitted (15±2) days after initial unilateral hemispheric ischemie stroke, with neuroimaging studies and with upper limb (UL) movement were studied, Lesions affecting the following structures were recorded: motor cortex, corona radiata, genu, anterior and posteror limbs of the internal capsule (PLIC), basal ganglia, and thalamus. x2 Analysis were used to study the significance of stroke location on UL motor recovery. Resuits: Patients with pure cortical stroke were likely to recover UL isolated movement (5 of 6) compared with pure subcortical (1 of 25) or mixed cortical-subcortical stroke location (3 of 30) (P＜0.01). Only 2 of 43 patients (4.7%)with PLIC involvement recovered isolated upper limb movement by the time of discharge, whereas 7 of the 18 patients (38.9%) without involvement of the PLIC recovered isolated upper limb movements (P＜0.05). Conclusions:The probability of recovery of UL movement decreases progressively with lesion location as follows: cortex, corona radiata, and PLIC. This is consistent with our current understanding of redundant cortical motor representation and convergence of corticofugal motor efferents as they pass through the corona radiata to the PLIC.
