LAUSR

Objective To investigate the relationship between changes of cortical hand motor representation and motor recovery of the affected hand in subacute stroke. Methods 17 patients with motor impairment of the affected hand were enrolled in an in-patient neurological rehabilitation program. Hand motor function tests (Wolf Motor Function Test, Action Research Arm Test) and the neurophysiological evaluations (resting motor threshold, motor evoked potentials, motor map area size, motor map area volume, motor map area location) were obtained from both hands and hemispheres at baseline, and two, four and six weeks of in-patient neurological rehabilitation. Results There was a wide spectrum of hand motor impairment at baseline and hand motor recovery over time. Hand motor function and recovery correlated significantly with (i) reduction of cortical excitability, (ii) reduction in size and volume of cortical hand motor representation and (iii) a medial and anterior shift of cortical hand motor representation within the contralesional hemisphere. Conclusion Recovery of motor function of the affected hand after stroke is accompanied by definite changes in excitability, size, volume and location of hand motor representation over the contralesional primary motor cortex. These measures may serve as surrogate markers for the outcome of hand motor rehabilitation after stroke.