236 Scientific Programme 22. European Stroke Conference © 2013 S. Karger AG, Basel 14 Brain imaging Healthy brain activity associated to upper limbs movements. Applications for motor rehabili-tation in Stroke A.C. Vidal1, P.B. Banca2, A. G. Pascoal3, G. Cordeiro4, J. Sargento-Freitas5, L. Cunha6, M. Caste-lo- Branco7 Univ Tecn Lisboa, Fac Motricidade Humana, CIPER, LBMF, P-1499-002, Lisbon, PORTU-GAL1, IBILI, Visual Neuroscience Laboratory, University of Coimbra, Coimbra, PORTUGAL2, Univ Tecn Lisboa, Fac Motricidade Humana, CIPER, LBMF, P-1499-002, Lisbon, PORTUGAL3, Stroke Unit, Department of Neurology, Coimbra University Hospital, Coimbra, Portugal, Coimbra, PORTUGAL4, Stroke Unit, Department of Neurology, Coimbra University Hospital, Coimbra, Por-tugal, Coimbra, PORTUGAL5, Stroke Unit, Department of Neurology, Coimbra University Hospi-tal, Coimbra, Portugal, Coimbra, PORTUGAL6, IBILI, Visual Neuroscience Laboratory, University of Coimbra, Coimbra, 7 Background: Neural circuits recruited in voluntary movements during shoulder elevation (ShoE-lev) are mostly in contralateral motor-sensory cortex and ipsilateral cerebellum. However, it is not known how this pattern would be modulated by the simultaneous contralateral upper limb motion restriction (CULMR). In this functional resonance magnetic imaging (3Tesla Magneton, Tim Trio, Siemens) study, we aim to identify and compare the neural circuitry involved in ShoElev when performed with and without simultaneous CULMR. Methods: Brain activity (BOLD signals) of 18 healthy participants (10 woman; 17 right handed; age=42.1±13.5 years) were scanned during two consecutive sessions for each hemisphere: 1) dominant ShoElev and 2) non-dominant ShoE-lev. Our experimental block design was composed by baseline and the two conditions (ShoElev with and without CULMR). During sub-phase of baseline the contralateral upper limb was placed passively under restriction. We have used BrainVoyager 2.4. (Software version) with “Random ef-fects analysis” and “False Discovery Rate” correction was used for image processing and statistics (p(corrected)<.05). Results: The activation of the contralateral motor-sensory cortex, and ipsilater-al cerebellum was confirmed for ShoElev. Only for dominant ShoElev this activation pattern was accompanied by deactivation of the ipsilateral motor-sensory cortex. Motion restriction was asso-ciated to deactivation of the circuits in the contralateral hemisphere. Sensory-motor cortex activity (number of statistically active voxels) decreased during dominant and, particularly in non-dominant ShoElev, with CULMR. Conclusion: The different observed brain patterns provide insight into the neural correlates of the role of hemispheric dominance in responses to shoulder elevation and for the role of limb restriction. These results may illuminate the design of rehabilitation strategies in clini-cally impaired patients, particularly in stroke. 13 Brain imaging Arterial spin labeling for hypoperfusion assessment in steno-occlusive disease: application of a current scanner based imaging protocol M.A. Mutke1, V.I. Madai2, F.C. von Samson-Himmelstjerna3, O. Zaro-Weber4, S. Martin5, S. Het-zer6, M. Guenther7, J. Sobesky8 Charité Universitätsmedizin Berlin, Berlin, GERMANY1, Charité Universitätsmedizin Berlin, Berlin, GERMANY2, Charité Universitätsmedizin Berlin, Fraunhofer/MEVIS, Berlin, GERMA-NY3, Charité Universitätsmedizin Berlin, Max-Planck-Institute for Neurological Research, Berlin, GERMANY4, Charité Universitätsmedizin Berlin, Berlin, GERMANY5, Berlin Center for Advanced Neuroimaging, Berlin, GERMANY6, Fraunhofer/MEVIS, Bremen, GERMANY7, Charité Universi-tätsmedizin Berlin, Berlin, GERMANY8 Background Arterial spin labeling (ASL) in magnetic resonance imaging (MRI) allows for a contrast-agent inde-pendent estimation of cerebral blood flow (CBF) and may be of value in diagnosis of cerebrovascu-lar disease. We assessed the performance of a commercially available ASL sequence in patients with steno-occlusive disease in comparison with DSC (dynamic susceptibility contrast)-MRI. Methods In a prospective, WHO-registered study (PEGASUS, registration number: DRKS00003198) patients with unilateral steno-occlusion of the ICA or MCA (internal or middle cerebral artery) >70% were imaged on a Magnetom Tim Trio 3T system (Siemens/Germany) as follows. Pulsed ASL (pASL): PICORE Q2TIPS, post labeling delay time TI= 1800ms, 50 measurements. DSC-MRI: single-shot GRE-EPI, 5ml Gadovist®. ASL-CBF maps were calculated online by the scanner console. DSC-CBF and TTP (time to peak) maps were obtained offline (PMA, ASIST-Japan). Coregistered maps of CBF and TTP were rated visually (site and extent of hypoperfusion; TTP delay; presence of arte-rial transit delay artifact ATDA on ASL maps). CBF values were compared by a region of interest (ROI) analysis (Spearman, Bland-Altman BA-plot). Results Of 28 patients imaged, 11 were excluded due to poor ASL image quality. On visual analysis, 11/17 patients showed DSC-CBF hypoperfusion, a corresponding ASL hypointensity was found in 2/11 (18%). 14/17 patients showed TTP delay, an arterial transit delay artifact in ASL was seen in 10/14 (71%). The quantitative correlation of CBF values for DSC and ASL was poor (rho=0,24), the BA plot showed a large spread of values (-100% up to +160%) owing to ATDA. Conclusion In patients with steno-occlusive disease, the investigated pASL sequence does not reliably quantify CBF, but identifies TTP delay in a qualitative manner by the presence of arterial transit delay arti-fact. New ASL sequences (3D GRASE, QUASAR) can correct for this delay and may allow for reli-able CBF measurement.
Karger_ESC London_2013
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