» Motorische Restitution nach Schlaganfall

Beyond Boarders: lessons from lesion mapping and functional representation
The brain is an organ highly specialized in its processing units. This specialization is made possible by unique anatomical characteristics, namely cytoarchitectural properties and white matter connectivity. Both develop in very specific time windows- mostly already during embryonal and the fetal stage and some reach their final structure after puberty. Although we know that the brain has some options for plasticity with respect to recruitment patterns, lateral inhibition and some microscopic changes on the level of Astrocytes and Synapses, these are very restricted during adulthood. Boarders in the brain and hard wires are defining and restricting plastic changes. For instance, a severe corticospinal tract (CST) damage at the height of the internal capsule shows very limited prognosis for upper limb outcome. With respect to cortical damage there is some range for plasticity in the same cytoarchitectural (Brodman) area but usually there is again a very restricted possibility to overtake function between cytoarchitectural regions with different characteristics. For instance, the premotor cortex might overtake some movement recruitment tasks of a damaged primary motor cortex but not most other parts of the frontal lobe. Boarders in the brain, as mapped with respect to cytoarchitectural characteristics (layers of cells in grey matter) and their structural connectivity (characterized by tractography), are therefore of outermost importance not only to understand brain function but also to understand processes of brain plasticity and recovery. As an example: severe destruction of the CST increases the need for intact white matter structures for working memory and interhemispheric processing for upper limb function (see for instance Domin et al., 2023).

New acceptance from STROKE for our secondary proposal in the Stroke Recovery group of ENIGMA: Domin M., Hordacre B, Hok P, 17 Autor*innen, Lotze M. (2023) White matter integrity and chronic post-stroke upper limb function: An ENIGMA Stroke Recovery analysis.

Im Update Neurorehabilitation fassen wir alle 2 Jahre die Daten zur Reporganisation und Plastizität nach Schlaganfall zusammen. Zuletzt in: Stephan K.M., Lotze M. (2024) Plastizität als Grundlage für die Erholung nach Schlaganfall , in: Update Neurorehabilitation; Ed: Platz T., Hippokrates Verlag; 1-26.

Vortrag zu MRT/TMS-Biomarkern zur Prognose der Handfunktion nach Schlaganfall
Überblick zur Neurophysiologie und Bildgebung zum Arm-Fähigkeits-Training: Platz T and Lotze M (2018) Arm Ability Training (AAT) Promotes Dexterity Recovery After a Stroke—a Review of Its Design, Clinical Effectiveness, and the Neurobiology of the Actions. Front. Neurol. 9:1082.

Neuerscheinung November 2018: Themenheft Neuromodulation in der Neurorehabilitation; Neuroreha 4/18 (Thieme Verlag):
Lotze M., Ladda AM. (2018) Grundlagen und Anwendung der Neuromodulation. Neuroreha 10 (04) in press.
Nikkhah G., Lotze M. (2018) Tiefe Hirnstimulation bei Patienten mit Bewegungsstörungen und Schmerzen. Neuroreha 10 (04) in press.

Lotze M., Roschka S., Domin M., Platz T. (2018) Predicting training gain for a three week period
of arm ability training in the subacute stage after stroke.
Frontiers Neurology/Stroke, 9:854.

Neuerscheinung Juni 2018: Themenheft Psychologische Störungen in der Neurorehabilitation; Neuroreha 2/18 (Thieme Verlag):
Funktionelle Anatomie der Emotionsstörungen (M. Lotze)
Übersicht Emotionsstörungen in der Rehabilitation (M. Lotze)

Historie der Schlaganfallstudien in unserer Arbeitsgruppe in Greifswald:
Projekt der Medizin-Doktoranden Moritz Loibl und Willy Beutling unter der Leitung von Martin Lotze 2007-2009

DFG-Projekt von 2009-2012 von Martin Lotze und Thomas Platz (Neurologisches Rehabilitationszentrum) mit Andrea Walz und Sybille Roschka

Landesgraduiertenstipendium (2015-2018) an Ulrike Horn

Förderung von Multi-Voxel-Pattern-Analytischen Ansätzen in der Prognostik des Schlaganfalloutcomes hinsichtlich der Handfunktion durch den Verbund Norddeutscher Universitäten April-Oktober 2016

Kooperationsprojekt zusammen mit Priv. Doz. Dr. Hubert Dinse von der Universität Bochum zum priming von Handfunktionstraining

Gollwitzer-Meier-Stipendium an Dr. Aija Marie Ladda 2018/19

Arm Ability Training für Patienten mit leichten Störungen der Handfunktion

Andrea Daniela Walz (ab 2009)
Karla Doppl (ab 2010)
Marie Ladda (ab 2011)
Julia Lindow (ab 2012)
Ulrike Horn (ab 2015)
Katharina Eyme (ab 2015)

Aktivierungskarten von 23 gesunden Probanden bei Durchführung einer einfachen Faustschlussbewegung im 1 Hz Rhythmus (A), beim visuell geführten Nachfahren einer Linie (aus dem Wiener Testsystem; B) und beim somatosensorisch geleiteten Umstecken von Stiften (C).

Weiterführende Literatur:
Domin M., Hordacre B, Hok P, 17 Autor*innen, Lotze M. (2023) White matter integrity and chronic post-stroke upper limb function: An ENIGMA Stroke Recovery analysis. STROKE, 54(9):2438-2441.
Veverka T., Hok P., Trnečková M., Otruba P., Zapletalová J., Tüdös Z., Lotze M., Kaňovský P., Hluštík P. (2023) Interhemispheric parietal cortex connectivity reflects improvement in post-stroke spasticity due to treatment with botulinum toxin-A, Journal of the Neurological Sciences, 446, 120588.
Liew, S.L., 24 authors, Domin, M., 13 authors, Lotze M., 21 authors, Chunshui Y (2022) A large, curated, open-source stroke neuroimaging dataset to improve lesion segmen-tation algorithms, Scientific Reports, 9(1), 320.
Zavaliangos-Petropulu A., 50 coauthors including Lotze M., Liew, L. (2022) Chronic stroke sensorimotor impairment is related to smaller hippocampal volumes: An ENIGMA analysis, Journal of the American Heart Association (JAHA) 11(10):e025109.
Liew S-L, Autoren Enigma Recovery Group; Lotze M. ..., Thompson P. (2021) Smaller spared subcortical nuclei are associated with worse post-stroke sensorimotor outcomes in 28 cohorts worldwide; Brain Communications 3(4):fcab216.
Hordacre B., Lotze M., Jenkinson M., Lazari A., Barras C.D., Boyd L., Hillier S. (2021) Fronto-parietal involvement in chronic stroke motor performance when corticospinal tract integrity is compromised. Neuroimage Clinical, 29:102558.
Platz T and Lotze M (2018) Arm Ability Training (AAT) Promotes Dexterity Recovery After a Stroke—a Review of Its Design, Clinical Effectiveness, and the Neurobiology of the Actions. Front. Neurol. 9:1082.
Liew, S.-L., ..10.., Boyd, L. A., Brodtmann, A., Buetefisch, C. M., Byblow, W. D., Cassidy, J. M., Conforto, A. B., ..17.., Lotze, M., ..15.., Stinear, C. M., ..3.., Villringer, A., Ward, N. S., ..6.., Cramer, S. C., & Thompson, P. M. (2020). The ENIGMA Stroke Recovery Working Group: Big data neuroimaging to study brain-behavior relationships after stroke. Hum Brain Mapping 43(1), 129–148.
Lotze M., Lindenberg P. (2019) Promoting manual dexterity recovery after stroke – understanding recovery mechanisms and therapeutic interventions. Editorial for Frontiers in Neurology/Stroke, 2019;10:815.
Lotze M., Ladda A.M., Stephan K.M. (2019) Cerebral Plasticity as the Basis of Recovery following Brain Damage, Neuroscience and Biobehavioral Reviews, 99:49-58.
Platz T., Lotze M. (2018) Arm Ability Training (AAT) promotes dexterity recovery after a stroke – a review of its design, clinical effectiveness and the neurobiology of the actions. Frontiers in Neurology, section Stroke, 9:1082.
Lotze M., Roschka S., Domin M., Platz T. (2018) Predicting training gain for a three week period of arm ability training in the subacute stage after stroke. Frontiers Neurology/Stroke, 9:854.
Stephan K. M. , Lotze M. (2017) Plastizität als Grundlage für die Erholung nach Schlaganfall. Neurol Rehabil 2017; 23(3), in press.
Grothe M, Doppl K, Roth C, Roschka S, Platz T, Lotze M. (2017) Changes in motor cortex excitability for the trained and non-trained hand after long-term unilateral motor training. Neuroscience Letters, 647:117-121.
Horn U., Grothe M., Lotze M. (2016) MRI-Biomarkers for hand motor outcome-prediction and therapy-monitoring following stroke. Neural Plasticity, 2016:9265621.
Horn, U., Roschka, S., Eyme, K., Walz, A.D., Platz, T., Lotze, M. (2016) Increased ventral premotor cortex recruitment after arm training in an fMRI study with subacute stroke patients. Behavioral Brain Research, 308: 152–159.
Lindow, J., Domin, M., Grothe, M, Horn, U, Eickhoff, S.B., Lotze, M. (2016) Connectivity-based predictions of hand motor outcome for mildly affected patients at the sub-acute stage after stroke. Frontiers Human Neuroscience, doi: 10.3389/fnhum.2016.00101.
Walz A., Doppl K., Kaza E., Roschka S., Platz T., Lotze M. (2015) Changes in cortical, cerebellar and basal ganglia representation after comprehensive long term unilateral hand motor training. Behavioral Brain Research, 278C:393-403.
Domin M., Langner S., Hosten N., Lotze M. (2014) Comparison of parameter threshold combinations for diffusion tensor tractography in chronic stroke patients and healthy subjects. PlosOne, 9(5):e98211.
Lotze M., Beutling W., Loibl M., Domin M., Platz T., Schminke U., Byblow, W. (2011) dPMC activation of the contralesional hemisphere is associated with the decrease of DTI-traces in chronic subcortical stroke patients. Neurorehabilitation and Neural Repair, 26(6):594-603.
Ladda AM., Pfannmöller JP., Kalisch T., Roschka S., Platz T., Dinse HR., Lotze M. (2013) Effects of combining 2 weeks of passive sensory stimulation with active hand motor training in healthy adults. PlosOne, 9(1):e84402.
Platz T., Roschka S., Doppl K., Roth C., Lotze M., Sack AT., Rothwell JC. (2012) Prolonged motor skill learning – a combined behavioural training and theta burst TMS study. Restaurative Neurology and Neuroscience, 30(3):213-24.
Loibl M., Beutling W., Kaza E., Lotze M. (2011) Non-effective increase of fMRI-activation for motor performance in elder individuals; Behavioural Brain Research, 223(2): 280-6.
Lotze, M. (2010) Functional lesions of the motor system with TMS– a challenge for individual functional mapping; Restaurative Neurology and Neuroscience 28(4):469-76.
Lotze. M., Sauseng P., Staudt, M. (2009) Functional relevance of ipsilateral motor activation in congenital hemiparesis as tested by fMRI-navigated TMS. Experimental Neurology, 217:440-3.
Lotze M., Markert J., Sauseng P., Hoppe J., Plewnia C., Gerloff C. (2006) The role of multiple contralesional motor areas for complex hand movements after internal capsular lesion. Journal of Neuroscience 26(22):6096-102.
Lotze M., Cohen L.G. Volition and Imagery in Neurorehabilitation (2006) Cogn. Behav. Neurol. 19: 135-140.
Lotze M., Grodd W., Rodden F.A., Gut E., Schönle P.W., Kardatzki B., Cohen L.G. (2006) Neuroimaging Patterns Associated with Motor Control in Traumatic Brain Injury. Neurorehabilitation and Neural Repair 20: 1-10.
Lotze M., Käthner R. J., Erb M., Cohen L.G., Grodd W., Topka H. (2003) Comparison of representational maps using fMRI and TMS. Clinical Neurophysiology 114(2): 306-312.
Lotze M., Braun C., Birbaumer N., Anders S., Cohen L.G. (2003) Motor learning elicited by voluntary drive. Brain 126 (4): 886-872.

Preise und Förderungen:
Die Arbeiten wurden 2004 mit dem wissenschaftlichen Förderpreis des Vereins zur Förderung Neurologischer Wissenschaften und 2006 mit dem Fürst Donnersmark Forschungspreis (15000€) ausgezeichnet
2015: Posterpreis (500€) für unser Projekt:"Connectivity-based predictions of hand motor outcome at the sub-acute stage after stroke" anlässlich der 59. Jahrestagung der Deutschen Gesellschaft für Klinische Neurophysiologie und Funktionelle Bildgebung.
Landesgraduiertenstipendium für Ulrike Horn 2015 zum Antrag mit dem Titel: Effektive Konnektivität der motorischen Restitutionsnetzwerke nach Schlaganfall