Hypoperfusion without stroke alters motor activation in the opposite hemisphere

John W. Krakauer, Petya D. Radoeva, Eric Zarahn, Jennifer Wydra, Ronald M. Lazar, Joy Hirsch, Randolph S. Marshall

Research output: Contribution to journalArticlepeer-review

28 Scopus citations


To specifically investigate the effect that large-vessel disease may have on cortical reorganization, we used functional magnetic resonance imaging to study patients with unilateral hemispheric hypoperfusion and impaired vasomotor reactivity from critical internal carotid or middle cerebral artery disease but without stroke. We hypothesized that when these patients used the hand contralateral to the hypoperfused hemisphere they would show unique activation in motor-related areas of the normally perfused hemisphere, that is, ipsilateral activation. We found that normal performance of two motor tasks was associated with increased ipsilateral hemispheric activation in the patients compared with age-matched controls. In addition, although task difficulty had an effect on ipsilateral activation, the increased ipsilateral activation seen in patients was not dependent on task difficulty. Our findings demonstrate that hemodynamic compromise alone is sufficient to cause atypical ipsilateral activation. This activation may serve to maintain normal motor performance.

Original languageEnglish (US)
Pages (from-to)796-802
Number of pages7
JournalAnnals of neurology
Issue number6
StatePublished - Dec 2004
Externally publishedYes

ASJC Scopus subject areas

  • Neurology
  • Clinical Neurology


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