The Effect Of Venlafaxine On Motor Functional Recovery In Patients With Acute Cerebral Infarction By FMRI: A Cross-sectional And Longitudinal Study

Objectives:1. To explore the feasibility and repeatability of fMRI technology’sapplication in locating the active areas of motor function in the cerebral cortexof healthy adults.2. To explore the dynamic changes in the functional reorganization and thepossible mechanism of neural plasticity of the motor cortex areas in patientswith acute cerebral infarction, utilizing both clinical behaviorism and fMRItechnology. 3. To analyze the therapeutic effect of the drug (Venlafaxine) on restoringthe motor cortex areas of patients with acute cerebral infarction utilizing clinicalbehaviorism and fMRI technology.Methods:1. All the subjects undergo assessments regarding clinical behavior, MRIexecutive ability and acute cerebral infarction to determine whether theexecutive ability at the distal ends of their upper limbs is suitable for MRIexamination to obtain objective clinical behavioral data.2. All the subjects undergo blood oxygenation level dependent-functionalmagnetic resonance imaging scans in both kinetic and resting states by means ofgradient echo and echo plannar imaging serials, while block designing isadopted for MRI’s mission design.3. Raw DICOM data obtained will first of all be converted into the NIfTIformat required by Statistical parametrical mapping using MRIcro, after whichimage data of the subjects will be processed and analyzed using the SPM5basedon the Matlab6.5analysis software platform.Results:1. Healthy adult subjects show no statistical significant difference in thetwo clinical behavioral assessment experiments; the contralateral SM1and SMCof motor cortex were steadily activated when the subjects move either the righthand or the left hand.2. Acute cerebral infarction patients demonstrate significantly improvedmotor ability in the hands in T2period than T1(P<0.05), and such ability issignificantly improved in T3than T2(P<0.05); the bilateral SM1, SMC andPMC of motor cortex were detected extensive activation-induced responses when moving the hand, activations in the motor cortex caused by handmovements of the patient displays the following pattern: acute stage—bilateralactivation, sub-acute stage—bilateral activation give priority to contralateral,chronic stage—contralateral activation.3. The motor ability of the hands of most patients with acute cerebralinfarction shows significant improvement in T2period compared with T1(P<0.05) due to administration of the drug (Venlafaxine), and also better resultsthan drug-free patients in the same period (T2period).Conclusions:1. This experiment offers feasibility and repeatability in locating andimaging the function areas of motor cortex in healthy adults.2. The motor ability of the hands of patients with acute cerebral infarctionsignificantly degenerates, and could gradually recover during sub-acute andchronic stages to a level while still distinctly lower than that of healthy groups;the bilateral SM1, SMC and PMC of motor cortex were detected extensiveactivation-induced responses when moving the hand;activations in the motorcortex caused by hand movements of the patient displays the following pattern:acute stage--bilateral activation, sub-acute stage--bilateral activation givepriority to contralateral, chronic stage--contralateral activation. Improvement inthe motor function of the patient’s hands is positively correlated to changes incontralateral SM1activation, while negatively correlated to changes inipsilateral SM1activation.3. Administration of the drug (Venlafaxine) produces certain positiveeffects on improving the motor ability of the hands of most patients with acute cerebral infarction, and is conducive to the long-term recovery of the patient’scerebral motor cortex areas.