Cortical Reorganization Following Modified Constraint-Induced Movement Therapy: A Study of 4 Patients With Chronic Stroke

fMRI activation map for the finger-tapping task in a single healthy subject showing cross-correlation statistics for the representative axial slices. Pictures are in neurologic convention (right on the picture corresponds to the right side of the brain). (A) Both hands finger-tapping task (Talairach coordinates of the centroid for right hemisphere: −32, −24, 48; for left hemisphere: 31, −24, 48). (B) Left hand finger-tapping task (Talairach coordinates of the centroid: −32, −24, 49). (C) Right hand finger-tapping task (Talairach coordinates of the centroid: 31, −24, 48). The color bar represents the significance level of activation: blue, r=0.3, red, r=0.7.

fMRI activation maps of patients 1, 3, and 4 in response to finger-tapping tasks performed with the affected hand; all pictures are in neurological convention. In patient 3, the proximal and distal motor improvement was associated with shift from scattered (A) pre-mCIMT BOLD signal changes in the left pre- and postcentral gyrus and right precentral gyrus to (B) the post-mCIMT BOLD signal changes in the subcortical and cortical structures in the right hemisphere. Patient 3 shows change in BOLD signal distribution from (C) the left inferior frontal gyrus to (D) the left middle frontal gyrus. Patient 4 shows no substantial change between (E) the pre-mCIMT and (F) post-mCIMT scans. The color bar represents the significance level of activation: blue, r=.45; red, r=0.8.