Predicting the motor recovery in stroke patients by use of cerebral blood flow:a pilot study

Objective To explore the value cerebral blood flow in prediction of motor recovery of stroke patients. Methods After evaluating the cerebral blood flow velocities of bilateral middle cerebral arteries with TCD during passive elbow movement, 68 patients with cerebral infarction were treated by rehabilitation therapy. The motor function of upper limbs was evaluated with Fugl Meyer before and after 6,12 weeks of treatment. The patients were divided into groups A and B according to the Fugl Meyer scales score of the paralytic upper limb at 12 weeks and the changes of cerebral blood velocities were compared between the two groups. Results The score of upper limb motor function were not different between group B and A before the treatment, but the score of group B was significantly higher than that of group A ( P 0.05) after 12 weeks of treatment. Patients with cerebral infarction all revealed increased contralateral cerebral blood velocity was observed when moving the uninvolved elbow (group A 9.25%± 1.99% , and group B 9.45%±1.33%)in patients, while increased bilateral blood velocitiesobserved when passively moving the involved paralytic elbow (the unaffected side 6.07%±1.35% and the affected side 9.48%±1.84% in group A, the unaffected side 9.86%±1.78% and the affected side 10.11%±1.88% in group B). The blood velocity in ipsilateral MCA of the paralytic limb increased significantly in group B as compared with that of group A ( P 0.05) . The scores of motor function of paralytic upper limbs at 12 weeks after treatment correlated positively with increased bilateral cerebral blood velocities ( P 0.05). Conclusion The activation levels of cerebral blood flow as related to movement offing the involved upper limb of stroke patient can roughly predict the degree of motor functional gain from rehabilitation.