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OBJECTIVE@#To observe the effects of acupuncture on neurologic function and serum inflammatory factors in patients after thrombolysis in acute ischemic stroke (AIS).@*METHODS@#A total of 102 AIS patients with onset to treatment time (OTT) ≤3 h were randomly divided into an observation group and a control group, 51 cases each group. In the control group, thrombolysis and conventional medical treatment were applied. On the basis of the treatment as the control group, acupuncture at Shuigou (GV 26), Zhongwan (CV 12), Qihai (CV 6), Neiguan (PC 6), etc. was applied in the observation group, 30 min each time, once a day. Both groups were treated for 2 weeks. Before and after treatment, the scores of National Institutes of Health stroke scale (NIHSS), modified Rankin scale (mRS), modified Barthel index (MBI) and serum level of homocysteine (Hcy), hypersensitive C-reactive protein (hs-CRP) were compared, and the clinical efficacy was evaluated in the two groups.@*RESULTS@#After treatment, the scores of NIHSS, mRS and serum level of Hcy, hs-CRP were decreased compared with those before treatment (P<0.05), while the MBI scores were increased (P<0.05) in the two groups. The scores of NIHSS, mRS and serum level of Hcy, hs-CRP in the observation group were lower than those in the control group (P<0.05, P<0.01), the MBI score in the observation group was higher than that in the control group (P<0.01). The total effective rate was 88.2% (45/51) in the observation group, which was superior to 70.6% (36/51) in the control group (P<0.05).@*CONCLUSION@#Acupuncture could promote the recovery of neurologic function in patients after thrombolysis in AIS, improve the ability of daily living, which may be related to reducing the level of inflammatory factors, thus inhibiting inflammatory response and improving cerebral ischemia reperfusion injury.
Subject(s)
Humans , United States , Ischemic Stroke , C-Reactive Protein , Acupuncture Therapy , Inflammation , Homocysteine , Hypersensitivity , Thrombolytic TherapyABSTRACT
Objective:To determine the predictive value of serum neurofilament light chain (NfL) on neurologic function in out-of-hospital cardiac arrest (OHCA) patients.Methods:The clinical data of 96 OHCA patients admitted to Cangzhou Central Hospital from January 2018 to March 2022 were retrospectively analyzed. According to the Glasgow-Pittsburgh cerebral performance category (CPC) upon hospital discharge, the patients were divided into the favorable neurologic function (grade 1-2) and poor neurologic function (grade 3-5) groups. The difference of serum NfL was compared between the two groups, and the relationship between serum NfL and neurologic function was assessed using correlation analysis and logistic regression analysis. The area under the curve (AUC), sensitivity, and specificity of serum Nfl were calculated by receiver operating characteristic (ROC) curve. Hanley & McNeil method test was used to compare the difference of AUCs between serum NfL and neuron specific enolase (NSE).Results:Twenty-six percent (25/96) patients were discharged with favorable neurologic function. Serum NfL in the favorable neurological function group was significantly lower than that in the poor neurologic function group (47.6 pg/mL vs. 261.4 pg/mL, P<0.001). Correlation analysis showed that serum NfL was positively correlated with neurologic function ( r=0.69, P<0.001). Logistic regression analysis showed that serum NfL was independently associated with neurological function ( OR=0.92, 95% CI: 0.86-0.98; P=0.010). ROC curve indicated that the AUC of serum NfL in predicting poor neurologic function was 0.95 (95% CI: 0.92-0.99), with a sensitivity of 84.5% and a specificity of 100% at the cutoff value of 80.0 pg/mL. The AUC of serum NSE in predicting poor neurologic function was 0.79 (95% CI: 0.69-0.89), with a sensitivity of 67.6% and a specificity of 80.0% at the cutoff value of 45.1 ng/mL. A pairwise comparison using Hanley & McNeil method showed that the AUC of serum NfL in predicting poor neurologic function was higher than that of NSE ( Z=3.22, P=0.001). Conclusions:Serum NfL is helpful for clinician to predict neurologic function in OHCA patients.
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OBJECTIVE:To investigate the effects of erythropoietin (EPO) combined with hyperbaric oxygen on neurologic function recovery and cerebral tissue metabolism of hypoxic-ischemic encephalopathy (HIE). METHODS:A total of 47 HIE neo-nates in our hospital during Sept. 2012-Apr. 2015 were selected and divided into observation group (25 cases) and control group (22 cases)according to random number table. Both groups received routine symptomatic supportive treatment as reducing intracrani-al pressure,correcting acidosis,maintaining electrolyte balance and controlling seizures. Control group was given hyperbaric oxy-gen therapy,compressing 15 min,inhaling 30 min,decompressing 15 min,qd. Observation group was additionally given rhEPO injection(CHO cell)200 U/kg,subcutaneously at the first time,intravenous injection from the second time,qd. Both groups were treated for consecutive 10 d. NBNA score,neural reflex recovery time,consciousness recovery time,the serum levels of NSE, MBP and S100B protein were observed in 2 groups before and after treatment. The occurrence of ADR was recorded. RESULTS:Before treatment,there was no statistical significance in NBNA score,serum levels of NSE,MBP and S100B protein between 2 groups (P>0.05). Five and ten days after treatment,NBNA scores of 2 groups were increased significantly compared to before treatment,and the observation group was significantly higher than the control group at corresponding period,with statistical signifi-cance (P0.05). After 10 days of treat-ment,serum levels of MBP in 2 groups were decreased significantly,and the observation group was significantly lower than con-trol group,with statistical significance (P0.05). CONCLUSIONS:For HIE neonates,EPO combined with hyperbaric oxygen can effectively promote neurologic function recovery and cerebral tissue metabolism with good safety.
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OBJECTIVE:To investigate the effects of simvastatin on neurologic function and prognosis of patients with cere-bral infraction. METHODS:A total of 82 patients with cerebral infarction selected from our hospital during Jan. 2015 to Jul. 2016 were divided into observation group and control group according to random number table,with 41 cases in each group. Control group received routine thrombolytic therapy and Aspirin enteric-coated tablets 100 mg orally,qd. Observation group was additional-ly given Simvastatin tablets 10 mg,qd,on the basis of control group. After 1 month of treatment,prognosis,ADE as well as NI-HSS scores before and after treatment were compared between 2 groups. Multiple factor Logistic regression analysis was conducted for clinical information of patients. RESULTS:The excellent rate of prognosis in observation group was 80.49％,which was signifi-cantly higher than 68.29％,with statistical significance(P0.05). After 1 month of treatment,NIHSS scores of 2 groups were decreased significantly,and the observation group was significantly lower than the control group,with statistical significance(P65 years,NI-HSS score <4 points at admission,combined diabetes,non-use of statins were independent risk factors which affected the survival of patients with cerebral infarction(P<0.05). CONCLUSIONS:Simvastatin can significantly improve the neurologic function and prognosis of patients with cerebral infarction,and reduce the incidence of ADE. Non-use of statins is an independent risk factor which affects the survival of patients.
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Objective To investigate the efficacy of frontoparietal drill versus parietal drill in the burring hole and drainage for chronic subdural hematoma(CSDH),and provide an evidence for clinical application.Methods A total of 82 patients with CSDH from January 2013 to January 2016 in our hospital were randomly divided into observation group and control group.The observation group chose frontoparietal drill which located at the front 1/4 point at the axial view with the thickest hematoma.Control group chose parietal drill which nearby the parietal tuberodties at the axial view with the thickest hematoma.The postoperative residual hematoma volume,intracranial gas volume,recurrence rate,neurologic function and mental state between two groups were compared.Results The postoperative residual hematoma volume,intracranial gas volume,the recurrence rate and CSS were lower compared with the control group,the differences were significant(P<0.05).The MMSE score of observation group were higher that of the control group,the difference was significant(P<0.05).Conclusion The frontoparietal drill has a better effect to remove the hematoma and promotes neural functional recovery.
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Objective To investigate the effects of baicalin on serum progesterone and related hormones in female normal and cerebral ischemia rats; To explore whether baicalin plays a role in cerebral protection of neurological functions by regulating progesterone levels.Methods With vaginal smear method, the adult estrus female SD rats were selected and divided into normal group, baicalin normal group, and molding groups. The left side of the middle cerebral artery of rats in the molding groups was blocked to establish the permanent middle cerebral artery occlusion (pMCAO). After modeling, the rats were randomly divided into model group, baicalin treatment group, progesterone treatment group and progesterone inhibitor group. The baicalin normal group and baicalin treatment group were given intraperitoneal injection of baicalin solution; the normal group and model group were given normal saline of the same quantity; progesterone treatment group was given intramuscular injection of progesterone; progesterone inhibitor group was given intraperitoneal injection of baicalin solution and intragastric administration of mifepristone solution.The neurological function deficit scores were evaluated and rat forelimb holding power was detected by Grip Strength Meter respectively at different time points. Serum was taken from the rats and the progesterone and related hormones levels in the serum of every group were measured by ELISA. Results Compared with normal group, neurological functions of rats in molding groups were damaged, and neural functional behavior scores of different time points were the most strongly increased (P0.05) and more significant improvement of the forelimb holding power (P0.05).Conclusion After applying mifepristone to block progesterone, baicalin neurologic protection is significantly inhibited. The results demonstrated that baicalin may play a role in cerebral protection via up-regulating serum progesterone level.
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OBJECTIVE:To explore the effects of risperidone combined Ningxin yizhi capsule on the cognitive function,neuro-logic function and living quality of cerebral infarction. METHODS:110 patients with cerebral infarction were randomly divided in-to control group(55 cases)and observation group(55 cases). All patients received aspirin,statins,penicillins,physical rehabilita-tion and other conventional treatment;based on it,control group orally received Risperidone tablet with initial dose of 0.5 mg, once a day,1 week later,the amount of drugs was adjusted according to the patient's tolerance and conditions,0.5 mg was in-creased every week,with maximum dose of less than 2 mg,no other antipsychotic drugs except risperidone. Observation group ad-ditionally received 0.9 g Ningxin yizhi capsule,3 times a day. The treatment course for both groups was 2 months. Montreal cogni-tive assessment (MoCA) score,neurobehavioral cognitive status tests scale (NCSE),National Institutes of Health Stroke Scale (NIHSS)score,activities of daily living scale(ADL)score and table of daily living-Barthel Index(Barthel-Index)before and af-ter treatment,and the incidence of adverse reactions in 2 groups were observed. RESULTS:Before treatment,there were no signifi-cant differences in the MoCA scores,NCSE scores,NIHSS scores,ADL scores and Barthel-Index in 2 groups (P>0.05). After treatment,the MoCA scores,NCSE scores,ADL scores and Barthel-Index in 2 groups were significantly higher than before,and observation group was higher than control group,NIHSS scores were significantly lower than before,and observation group was lower than control group,the difference was statistically significant(P0.05). CONCLUSIONS:Based on the conventional treatment,risperidone combined Ningxin yizhi capsule can significantly improve the cognitive function,neurologic function and living quality of cerebral infarction,with good safety.
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OBJECTIVE:To observe clinical efficacy and safety of edaravone combined with butyl phthalide in the treatment of acute ischemic stroke (AIS). METHODS:258 AIS patients were randomly divided into observation group and control group, with 129 cases in each group. Both groups were given routine treatment as antiplatelet,improving microcirculation,controlling blood pressure,lowering blood glucose,regulating blood lipid,keeping plaque stable,nourishing brain cells. Control group was additionally given Butyl phthalide capsules orally,200 mg,tid. Observation group was additionally given Edaravone injection 30 mg added into Sodium chloride injection 100 ml,ivgtt,bid,on the basis of control group. Both groups continuously received 14 days of treatment. The serum inflammatory factor,miR-222 and neurologic impairment score of 2 groups were observed before treatment,7,14 d after treatment. Clinical efficacies and the occurrence of ADR were compared between 2 groups. RESULTS:There was no statistical significance in the serum inflammatory factor,miR-222 and neurologic impairment score between 2 groups before treatment(P>0.05). The serum inflammatory factor and neurologic impairment score of 2 groups were decreased significant-ly 7,14 d after treatment,while serum levels of miR-222 were increased significantly;the observation group was significantly bet-ter than the control group,with statistical significance(P<0.05). Total effective rate of observation group was 92.2%,which was significantly higher than that of control group (69.8%),with statistical significance (P<0.05). No obvious ADR was found in 2 groups. CONCLUSIONS:Edaravone combined with butyl phthalide is effective in the treatment of AIS,and can significantly de-crease serum inflammatory factor level,promote the expression of miR-222 and improve neurologic function with good safety.
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@#Objective To study the effects of thrombolysis on short- and long-term outcome in acute cerebral infarction patients. Methods The patients accepted thrombolysis and remained severe neurologic deficits were as observation group (n=29), and the patients without thrombolysis matching the onset time and severity of disease were as control group (n=94). They were assessed with National Institute of Health Stroke Scale (NIHSS), Manual Muscle Test (MMT), Brunnstrom Grade, modified Barthel Index (MBI) when they admitted and discharged, and with modified Rankin Scale (mRS) 6 months later. Results The scores of MMT, MBI and Brunnstrom grade improved in both groups when discharged (P<0.05), except the NIHSS in the control group, and the scores of NIHSS and MBI improved more in the observation group than in the control group (P<0.05). The score of mRS was better in the observation group than in the control group 6 months later (P<0.05). Conclusion Thrombolysis can improve the neurologic function and activities of daily living in the acute stage of cerebral infarction, as well as the long-term outcome of activities.
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Objective To study the effects of thrombolysis on short-and long-term outcome in acute cerebral infarction patients. Meth-ods The patients accepted thrombolysis and remained severe neurologic deficits were as observation group (n=29), and the patients without thrombolysis matching the onset time and severity of disease were as control group (n=94). They were assessed with National Institute of Health Stroke Scale (NIHSS), Manual Muscle Test (MMT), Brunnstrom Grade, modified Barthel Index (MBI) when they admitted and dis-charged, and with modified Rankin Scale (mRS) 6 months later. Results The scores of MMT, MBI and Brunnstrom grade improved in both groups when discharged (P<0.05), except the NIHSS in the control group, and the scores of NIHSS and MBI improved more in the observa-tion group than in the control group (P<0.05). The score of mRS was better in the observation group than in the control group 6 months later (P<0.05). Conclusion Thrombolysis can improve the neurologic function and activities of daily living in the acute stage of cerebral infarc-tion, as well as the long-term outcome of activities.
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Objective To investigate neurological function, volume of cerebral infarction, changes of lipid peroxidation, and the intervention effect of compound angelica injection (CAI) on rats with focal cerebral ischemia injury. Methods Models of rat with cerebral ischemia were reproduced by middle cerebral artery occlusion (MCAO). All animals were randomly divided into sham-operation group, model group, CAI group, and edaravone group. 1 hour after the models were established, rats in the sham-operation group and model group received intraperitoneal injection with normal saline, while rats in CAI group and edaravone group received intraperitoneal injection with relevant medicine for continuing 7 days. Volume of cerebral infarction was detected by Tetrazole staining method, neurologic function were detected by neuroethology, and concentration of MDA in brain tissue was also detected. Results After 7-day cerebral ischemia, compared with the model group, volume of cerebral infarction in CAI group was significantly reduced (P<0.05), and the concentration of MDA was a little lower. Conclusion CAI has significant protective effects which can significantly improve neurological function, reduce volume of cerebral infarction, and alleviate the effects of lipid peroxidation of rats with focal cerebral ischemia injury.
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Objective To evaluate clinical therapeutic efficacy and safety of joint application of Monosialotetrahexosylganglioside Sodium and the Vinpocetine in patients with acute cerebral infarction.Methods 60 patients with acute cerebral infarction, admitted to Wuxi People's Hospital Attached to Nanjing Medical University from January 2013 to July 2015, were randomly divided into observation group(n=30) and control group(n=30).They were both treated by identical basis therapy, such as antiplatelet, dilute blood viscosity, neurotrophy therapy and symptomatic treatment.The patients in the observation group were treated by joint application of Monosialotetrahexosylganglioside Sodium and the Vinpocetine on the identical basis therapy.On the pretherapy and post-treatment day, the National Institutes of Health Stroke Scale (NIHSS), Barthel Index(BI), neuron specific enolase(NSE), hemodynamic indexes and efficiency of clinical treatment in these patients were performed.Blood routine examinations, hepatorenal function and ECG were monitored.CT SCan was employed for ICH and drug relative hemorrhage and adverse drug reaction( ADR) were recorded in detail.Results After treatment, 2 groups of NIHSS, BI score, blood rheology index, NSE level compared with before treatment improved significantly, the difference was significant (P<0.05).NSE, hemorheology and total effective rate of the observation group were better than the control group(P<0.05).The clinical total effective rate was 93.3% in treatment group and 76.6% in control group (P<0.05).During therapy period, There was no adverse reaction in 2 groups.Conclusion Joint application of Monosialotetrahexosylganglioside Sodium and the Vinpocetine is safe and effective in treating patients with acute cerebral infarction, through improving the clinical neurological deficits, blood rheology indicators and activity of daily living.
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Objective To investigate effect of dicoumarol on the expression of serum tumor necrosis factor-α( TNF-α) in patients with acute cerebral infarction.Methods Eighty cases patients with acute cerebral infarction were admitted and randomly divided into two groups by digital draw:control group and observation group, 40 cases in each group.The control group were given conventional therapy for treatment of acute cerebral infarction, and observation group were given dicoumarol thrombolysis on the basis of control group.The serum TNF-αlevel and neurologic impairment score were compared between two groups pre-and post-treatment.Results After treatment of 6 h, the serum TNF-αlevel in observation group was significantly lower than that in control group (P<0.05).After treatment of 24 h, 48 h and 30 d, there were no significant differences of serum TNF-αlevels between two groups.After treatment of 5 d, 14 d and 28 d, the neurological deficit scores in observation group were significantly higher than those in control group (P<0.05).Conclusion Dicoumarol could effectively reduce TNF-αlevels in serum and extent of cerebral cell damage in patients.
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Objective The purpose of this study is to select suitable ages of rats for the CPR ( cardiopulmonary resuscitation) animal model.The neurological function score and subgroups analysis are evaluated in 2 month old and 4 month old animal groups.Methods Based on the evaluation of physiological indexes including ECG, blood pressure and neurological function defect score ( NDS) and subgroup analysis, the stability of CPR rats model was compared between 2 month old and 4 month old animal groups.Results The results showed that, the model rate of the ventricular fibrillation was induced by electrical stimulation , the 4 month old group was 87.5%, significantly higher than the 2 month old group, however, there was no significant difference between the two groups in the mortality rate;For the changes of blood pressure during the process of CA( cardiac arrest) induced by electrical stimulation, the 4 month old group was significantly lower than the 2 month old group (P <0.01); for the NDS at each time point after CPR, there was no significant difference between the two groups; however, the NDS subgroup analysis at different time points showed that there were different degrees of differences between the two age groups ( P <0.05) .Comparing with the 2 month old group, the 4 month old group had a stable process during the animal model preparation, had an obvious cerebral blood hypoperfusion phenomenon and aggravation of brain injury after CPR.Conclusion The 4 month old rats are more suitable for preparation of CPR animal mode , the model rate is high, the brain injury aggravate.It is more suitable evaluation for basic research and treatment of CPR.
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Objective To study the effectiveness and safety of therapeutic mild hypothermia in patients successfully resuscitated from cardiac arrest using a meta-analysis.Methods We searched the MEDLINE (1966-April 2012),OVID (1980 to April 2012),EMBASE (1980 to April 2012),Chinese bio-medical literature & retrieval system (CBM) (1978 to April 2012),Chinese medical current contents (CMCC) (1995 to April 2012),and Chinese medical academic conference (CMAC) (1994 to April 2012).Studies were included (1) the study design was a randomized controlled trial (RCT); (2) the study population included patients successfully resuscitated from cardiac arrest,and received either conventional post-resuscitation care with normothermia or mild hypothermia; (3) the study provided data about good neurologic outcome and survival till hospital discharge.Relative risk (RR) and 95％ corfidence interval (CI) were used to pool the effect.Results The study included four RCTs with a collected total of 417 patients successfully resuscitated from cardiac arrest.Compared to conventional post-resuscitation care with normothermia,patients in the hypothermia group were more likely to have good neurologic outcome (RR =1.43,95％ CI 1.14 ～ 1.80,P =0.002) and were more likely to survive till hospital discharge (RR =1.32,95％ CI 1.08 ～ 1.63,P =0.008).From all over the studies there was no significant difference in reported adverse events between the normothermia and hypothermia group (P ＞ 0.05).There did not exist heterogeneity and publication bias.Conclusions Therapeutic mild hypothermia improves neurologic outcome and survival in patients successfully resuscitated from cardiac arrest.
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BACKGROUND:Spinal canal decompression and fusion combined with pedicle screw fixation has become the main method for the treatment of thoracolumbar fracture and dislocation. OBJECTIVE:To restore the vertebral height of the patients with thoracolumbar fracture and dislocation who underwent subtotal resection and decompression through titanium cage packed with autologous cancel ous bone and pedicle screw fixation. METHODS:Thirty-one patients with thoracolumbar fracture and dislocation treated in the Shanghai 6th People’ s Hospital of Shanghai Jiao Tong University from February 2007 to September 2011 were selected. Al the patients received subtotal resection, spinal canal decompression and titanium cage packed with autologous cancel ous bone and pedicle screw fixation. Imaging examination was performed before and after treatment to observe the recovery of vertebral sequence, vertebral height and Cobb angle, as wel as the recovery of nerve function. RESUTLS AND CONCLUSION:The patients were fol owed-up for 12 months, and al the patients healed wel after treated with titanium cage packed with autologous cancel ous bone and pedicle screw fixation, and there was no loosening, shedding or breakage after pedicle screw fixation. During reexamination, the grafts fusion, good deformity correction, basic recovery of vertebral height and good recovery of Cobb angle were observed. Seven cases had neurological function recovery, and among them, six cases raised for one degree, one case raised for two degrees, and another 22 cases without recovery. Case analysis and relative researches showed that subtotal resection and decompression and titanium cage packed with autologous cancel ous bone and pedicle screw fixation can reduce the loss of correction of the patients with thoracolumbar fracture and dislocation, restore the vertebral height, and enhance the stability of the vertebral body.
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OBJECTIVE:To observe the clinical efficacy of Danhong injection and its impact on plsma levels of TNF-? and IL-6 in patients with acute cerebral infarction.METHODS:80 patients with acute cerebral infarction were randomly divided into two groups: 40 in control group were treated with conventional therapy, while the other 40 in treatment group with conventional therapy in combination with Danhong injection.The changes of neurologic function score(NIHSS), clinical effect and the plasma levels of TNF-? and IL-6 after 2-week treatment were compared between the two groups. RESULTS: There were signficnant differences in neurologic impairment score(NIHSS), clinical effect and the plasma levels of TNF-? and IL-6 between the treatment group and the control group after treatment (P
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Objective To investigate the protective effect of local mild hypothermia on the ischemic cerebral tissues. Methods A model of middle cerebral artery occlusion was prepared in Wistar rats to compare the difference of the cerebral infarction volume and neurologic function and the serum concentration of neuron-specific enolase (NSE) between the local mild hypothermia group and the normal temperature group. Results It was found that the cerebral infarction volume was 84.90?11.36 and 128.95?13.42 mm 3 in the local mild hypothermia group and the normal temperature group, the neurologic function score 0.95?0.17 and 1.60?0.24, and the serum concentration of NSE 9.19?3.42 and 13.55?4.07ng/ml,respectively. The differences between the two groups were statistically significant. Conclusion The findings of this study suggest that the local mild hypothermia treatment exerted protective effect on the ischemic neurons.
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Objective To observe the effect of ecdysterone(EDS)on the level of VEGF protein in the brain,angiogenesis and neurologic function after focal cerebral ischemia in rats.Methods Rat with focal cerebral ischemia were established by occluding their middle cerebral artery.The established rats(n=36)were randomly and equally divided into EDS treatment group and ischemia group.EDS(20 mg?kg-1?d-1 for 7 d)was intraperitoneally injected into the rats of EDS treatment group 2 h after operation,and the animal of ischemia group received an intraperitoneal injection of the same solvent as in EDS group.Another 6 rats served as normal control.Rats were sacrificed in 7,14 and 21 d after operation,and the VEGF protein level and microvessel density(MVD)was detected with immunohistochemical methods and analyzed quantitatively with image system.Effect of EDS on neurologic recovery following brain ischemia were assessed using the neurologic severity scores(NSS).Results VEGF expression was not seen in normal control,and was higher in ischemia group than in the EDS treatment group at day 7 and 14,but the significant difference was only observed at day 7(P
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OBJECTIVE: To investigate cortical reorganization of the brain during voluntary activities of the hand in patients with subcortical cerebral infarction. METHOD: Twelve patients with first-ever subcortical brain lesion causing hemiparesis had been evaluated with functional MRI. Bilateral hand clenching was done to test voluntary hand activities. Recovery period ranged from 2 to 36 months. RESULTS: During the unaffected hand movement, activation of contralateral primary sensorimotor cortex (SMC) were recorded in all cases and supplmentary motor area (SMA) in 1 case. The affected hand movement showed activation of the cotralateral SMC in all cases, ipsilateral SMC in 4 cases, SMA in 4 cases and contralateral prefrontal area in 2 cases. As for the contralateral SMC, affected hand movement showed more increased activation than the unaffected. For the bilateral SMC activation during movement of the affected hand, contralateral SMC activation was greater than the ipsilateral. CONCLUSION: Ipsilateral activation of the SMC, SMA, prefrontal area and increased activation of the contralateral SMC during affected hand movement suggest that these may play an important role in the reorganization of sensory and motor system in stroke patients with subcortical lesion. Functional MRI studies of patients who recovered from subcortical stroke provide evidence for several process that may be related to restoration of neurologic function.