Article

Stroke patients with mild-moderate upper extremity motor impairments
and minimal sensory and cognitive deficits provide a useful model to study
recovery and improve rehabilitation. Laboratory-based investigators use lesioning
techniques for similar goals. OBJECTIVE: To determine whether stroke lesions in
an upper extremity rehabilitation trial cohort match lesions from the preclinical
stroke recovery models used to drive translational research. METHODS: Clinical
neuroimages from 297 participants enrolled in the Interdisciplinary Comprehensive
Arm Rehabilitation Evaluation (ICARE) study were reviewed. Images were
characterized based on lesion type (ischemic or hemorrhagic), volume, vascular
territory, depth (cortical gray matter, cortical white matter, subcortical), old
strokes, and leukoaraiosis. Lesions were compared with those of preclinical
stroke models commonly used to study upper limb recovery. RESULTS: Among the
ischemic stroke participants, median infarct volume was 1.8 mL, with most lesions
confined to subcortical structures (61%) including the anterior choroidal artery
territory (30%) and the pons (23%). Of ICARE participants, <1% had lesions
resembling proximal middle cerebral artery or surface vessel occlusion models.
Preclinical models of subcortical white matter injury best resembled the ICARE
population (33%). Intracranial hemorrhage participants had small (median 12.5 mL)
lesions that best matched the capsular hematoma preclinical model. CONCLUSIONS:
ICARE subjects are not representative of all stroke patients, but they represent
a clinically and scientifically important subgroup. Compared with lesions in
general stroke populations and widely studied animal models of recovery, ICARE
participants had smaller, more subcortically based strokes. Improved
preclinical-clinical translational efforts may require better alignment of
lesions between preclinical and human stroke recovery models.

Langue : ANGLAIS