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Behavioural Neurology
Volume 24, Issue 2, Pages 117-122
Short Communication

Cerebral Perfusion in Chronic Stroke: Implications for Lesion-Symptom Mapping and Functional MRI

Jessica D. Richardson,1 Julie M. Baker,1 Paul S. Morgan,2 Chris Rorden,3 L. Bonilha,4 and Julius Fridriksson1

1Department of Communication Sciences and Disorders, University of South Carolina, Columbia, SC, USA
2Department of Radiology and Radiological Science, Medical University of South Carolina, Columbia, SC, USA
3Georgia State/Georgia Tech Center for Advanced Brain Imaging, GA, USA
4Department of Neurosciences, Medical University of South Carolina, Columbia, SC, USA

Received 20 May 2011; Accepted 20 May 2011

Copyright © 2011 Hindawi Publishing Corporation and the authors. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.


Lesion-symptom mapping studies are based upon the assumption that behavioral impairments are directly related to structural brain damage. Given what is known about the relationship between perfusion deficits and impairment in acute stroke, attributing specific behavioral impairments to localized brain damage leaves much room for speculation, as impairments could also reflect abnormal neurovascular function in brain regions that appear structurally intact on traditional CT and MRI scans. Compared to acute stroke, the understanding of cerebral perfusion in chronic stroke is far less clear. Utilizing arterial spin labeling (ASL) MRI, we examined perfusion in 17 patients with chronic left hemisphere stroke. The results revealed a decrease in left hemisphere perfusion, primarily in peri-infarct tissue. There was also a strong relationship between increased infarct size and decreased perfusion. These findings have implications for lesion-symptom mapping studies as well as research that relies on functional MRI to study chronic stroke.