Cortical reorganization of sensori-motor function in a patient with cortical infarct

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We describe a patient with cortical infarct, whose sensori-motor function for the hand seemed to be reorganized into the lateral area, as demonstrated by functional MRI (fMRI). A 59-year-old male patient presented with severe sensori-motor dysfunction of the left hand, which first occurred at the onset of an infarct in the right primary sensori-motor cortex (SM1) centered on the precentral knob. The sensori-motor function of the affected hand recovered to a normal state at 6 months from onset. fMRI was performed using the blood oxygen level-dependent technique at 1.5T with a standard head coil (at 6 months from onset). The active and passive movements were performed at the metacarpophalangeal joint using a specially equipped apparatus, and touch stimulation was applied on the dorsum of the hand using a rubber brush. The contralateral SM1 centered on the precentral knob was found to be activated during the active movements, passive movements, and touch of the unaffected (right) hand movements. By contrast, the lateral area of the infarcted SM1 of the right hemisphere was activated during the three kinds of stimulation of the affected hand. We conclude that the sensori-motor function of the affected hand seemed to have been reorganized into the lateral area of the infarcted SM1.