Increased ventral premotor cortex recruitment after arm training in an fMRI study with subacute stroke patients.

To investigate therapy associated changes in the cerebral representation of movement after stroke, we used functional magnetic resonance imaging (fMRI) during an active and a passive motor task for the affected and unaffected hand before and after a three week comprehensive hand motor training. Twelve patients in the subacute phase from 2 to 9 weeks after mild to moderate motor stroke were recruited. During fMRI, the active task comprised fist clenching, which was precisely controlled for motor performance by visual feedback of force and frequency. The passive task consisted of wrist flexion-extension of 1Hz frequency by means of a pneumatic driven splint. Arm Ability Training (AAT) was conducted one hour per day over 3 weeks in addition to inward rehabilitative therapy. Performance gain was tested using movements trained with AAT, but also with conventional hand motor tests (Nine-Hole-Peg Test, Box-and-Block Test). Rehabilitation therapy and AAT resulted in considerable improvement of performance in trained tasks and other hand motor functions (e.g., Nine-Hole-Peg Test). FMRI activation in the ventral premotor cortex (vPMC) of the lesioned hemisphere increased over time for the active task only for the affected hand. No such change was present for the passive wrist extension task or the active task with the unaffected hand. In addition, only for the post measurement of the active task performed with the affected hand, bilateral vPMC shows a more pronounced activation than in healthy controls. This finding contradicts the simple "near to normal is good recovery" opinion.

Graded motor imagery and the impact on pain processing in a case of CRPS.

OBJECTIVE: Graded motor imagery (GMI) shows promising results for patients with complex regional pain syndrome (CRPS). METHODS: In a case with chronic unilateral CRPS type I, we applied GMI for 6 weeks and recorded clinical parameters and cerebral activation using functional magnetic resonance imaging (fMRI; pre-GMI, after each GMI block, and after 6 mo). Changes in fMRI activity were mapped during movement execution in areas associated with pain processing. A healthy participant served as a control for habituation effects. RESULTS: Pain intensity decreased over the course of GMI, and relief was maintained at follow-up. fMRI during movement execution revealed marked changes in S1 and S2 (areas of discriminative pain processing), which seemed to be associated with pain reduction, but none in the anterior insula and the anterior cingulate cortex (areas of affective pain processing). After mental rotation training, the activation intensity of the posterior parietal cortex was reduced to one third. DISCUSSION: Our case report develops a design capable of differentiating cerebral changes associated with behavioral therapy of CRPS type I study.

Distinct responses of human granulosa lutein cells after hCG or LH stimulation in a spheroidal cell culture system.

The growth and development of the corpus luteum (CL) is regulated by gonadotropic hormones. It is formed by granulosa cells (GCs), theca cells, and endothelial cells, and is the primary source of circulating progesterone. During early pregnancy only human chorionic gonadotropin (hCG) but not luteinizing hormone (LH) extends the life span of the CL, although hCG and LH interact with the same receptor and have similar actions on the CL. In this study a recently by our group established spheroidal GC culture assay served as a model of CL development on which we compared the actions of the gonadotropic hormones LH and hCG. To find out which signal pathways take part in the hormonal regulation of GC we stimulated GC-spheroids with modulators of protein kinases A and C dependent signaling cascades and determined their impact on sprout forming activity in GC. Our results indicate that PKA-dependent signaling pathways play a major role in mediating the hormonal-induced signaling cascades leading to sprouting in GC. Furthermore, this study strongly indicates that the different effects of hCG and LH in the maintenance of the CL may be reasoned in different signal transduction pathways triggered by hCG or LH.