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000012585 0247_ $$2DOI$$a10.1002/ana.22237
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000012585 084__ $$2WoS$$aClinical Neurology
000012585 084__ $$2WoS$$aNeurosciences
000012585 1001_ $$0P:(DE-Juel1)VDB75806$$aWang, L.E.$$b0$$uFZJ
000012585 245__ $$aNoradrenergic enhancement improves motor network connectivity in stroke patients
000012585 260__ $$aHoboken, NJ$$bWiley-Blackwell$$c2011
000012585 300__ $$a375 - 388
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000012585 440_0 $$0451$$aAnnals of Neurology$$v69$$x0364-5134$$y2
000012585 500__ $$aThis research was supported by a grant from the Human Brain Project (R01-MH074457-01A1 to S.B.E.) and the Initiative and Networking Fund of the Helmholtz Association within the Helmholtz Alliance on Systems Biology (Human Brain Model to S.B.E.).
000012585 520__ $$aBoth animal and human data suggest that noradrenergic stimulation may enhance motor performance after brain damage. We conducted a placebo-controlled, double-blind and crossover design study to investigate the effects of noradrenergic stimulation on the cortical motor system in hemiparetic stroke patients.Stroke patients (n = 11) in the subacute or chronic stage with mild-to-moderate hand paresis received a single oral dose of 6 mg reboxetine (RBX), a selective noradrenaline reuptake inhibitor. We used functional magnetic resonance imaging and dynamic causal modeling to assess changes in neural activity and interregional effective connectivity while patients moved their paretic hand.RBX stimulation significantly increased maximum grip power and index finger-tapping frequency of the paretic hand. Enhanced motor performance was associated with a reduction of cortical "hyperactivity" toward physiological levels as observed in healthy control subjects, especially in the ipsilesional ventral premotor cortex (vPMC) and supplementary motor area (SMA), but also in the temporoparietal junction and prefrontal cortex. Connectivity analyses revealed that in stroke patients neural coupling with SMA or vPMC was significantly reduced compared with healthy controls. This "hypoconnectivity" was partially normalized when patients received RBX, especially for the coupling of ipsilesional SMA with primary motor cortex.The data suggest that noradrenergic stimulation by RBX may help to modulate the pathologically altered motor network architecture in stroke patients, resulting in increased coupling of ipsilesional motor areas and thereby improved motor function.
000012585 536__ $$0G:(DE-Juel1)FUEK409$$2G:(DE-HGF)$$aFunktion und Dysfunktion des Nervensystems (FUEK409)$$cFUEK409$$x0
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000012585 650_2 $$2MeSH$$aAdrenergic Uptake Inhibitors: therapeutic use
000012585 650_2 $$2MeSH$$aAdult
000012585 650_2 $$2MeSH$$aAged
000012585 650_2 $$2MeSH$$aCross-Over Studies
000012585 650_2 $$2MeSH$$aDouble-Blind Method
000012585 650_2 $$2MeSH$$aHand Strength: physiology
000012585 650_2 $$2MeSH$$aHumans
000012585 650_2 $$2MeSH$$aMagnetic Resonance Imaging
000012585 650_2 $$2MeSH$$aMale
000012585 650_2 $$2MeSH$$aMiddle Aged
000012585 650_2 $$2MeSH$$aMorpholines: therapeutic use
000012585 650_2 $$2MeSH$$aMotor Cortex: drug effects
000012585 650_2 $$2MeSH$$aMotor Cortex: physiopathology
000012585 650_2 $$2MeSH$$aParesis: drug therapy
000012585 650_2 $$2MeSH$$aParesis: etiology
000012585 650_2 $$2MeSH$$aParesis: physiopathology
000012585 650_2 $$2MeSH$$aPsychomotor Performance: drug effects
000012585 650_2 $$2MeSH$$aRecovery of Function: drug effects
000012585 650_2 $$2MeSH$$aStroke: complications
000012585 650_2 $$2MeSH$$aStroke: drug therapy
000012585 650_2 $$2MeSH$$aStroke: physiopathology
000012585 650_7 $$00$$2NLM Chemicals$$aAdrenergic Uptake Inhibitors
000012585 650_7 $$00$$2NLM Chemicals$$aMorpholines
000012585 650_7 $$098769-81-4$$2NLM Chemicals$$areboxetine
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000012585 7001_ $$0P:(DE-Juel1)131720$$aFink, G. R.$$b1$$uFZJ
000012585 7001_ $$0P:(DE-HGF)0$$aDiekhoff, S.$$b2
000012585 7001_ $$0P:(DE-HGF)0$$aRehmke, A.K.$$b3
000012585 7001_ $$0P:(DE-Juel1)131678$$aEickhoff, S. B.$$b4$$uFZJ
000012585 7001_ $$0P:(DE-HGF)0$$aGrefkes, C.$$b5
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