Active and passive movement of the affected hand after ischemic stroke

Objective To study the effects of active and passive movement of the affected hand after ischemic stroke on brain activity patterns using blood oxygenation level-dependent functional magnetic resonance imaging (BOLD-fMRI) and to explore the central mechanism of movement treatment for hand disability.Methods Five pa-tients with subcortical cerebral infarction in Brunnstrom stages 1 to 3 (both upper limb and hand affected) were investigated using BOLD-fMRI during active and passive clenching and relaxing of the affected hand.Statistical parametric mapping software (SPM5) was used to integrate the activity data and display them in one standard brain map.The activated areas were then compared.Results The BOLD-fMRI signals aroused by both active and passive move-ment were enhanced in the contralateral sensorimotor cortex,the contralateral premotor cortex,bilaterally in the sup-plementary motor area and in the bilateral cerebellum.Both movements also activated the ipsilateral sensorimotor cor-tex and premotor cortex,which are not normally activated during such movements in healthy people.The areas were more extensive and the activation was stronger during passive movement.Moreover,the activated brain areas induced by active movement were mainly on the contralateral side,while passive movement induced activation distributed over both hemispheres almost evenly.Conclusions Both active and passive movement significantly activate the brain areas responsible for movement of the affected hand.Both are useful for boosting brain reorganization after stroke. Key words: Ischemic stroke;  Functional magnetic resonance imaging;  Active movement;  Passive movement ;  Hand rehabilitation