I'm Aoi Hashima , an occupational therapist working in Saga Sumai and Fukuoka.
I've written several articles on spasticity in the past.
"Position of Spastic Limbs and Common Pathogenic Muscles"
I am Aoi Hashima, an occupational therapist working in Saga Sumai and Fukuoka. I've been sorting through spasticity-related stuff for the past few days. "The occurrence of spasticity depends on whether or not rehabilitation treatment is carried out" Saga Residence, Fukuoka Work ...
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"Development of spasticity depends on rehabilitation"
I am Aoi Hashima, an occupational therapist working in Saga Sumai and Fukuoka. After a stroke, emergency treatment is usually given in an acute hospital, followed by admission to a rehabilitation ward. …
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Amibulo.jp
"Summary of Spasticity"
I am Aoi Hashima, an occupational therapist working in Saga Sumai and Fukuoka. More recently, "Where do spasms come from?", "Is there a way to make spasms worse with rehabilitation?"
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Amibulo.jp
Stiffness (spasms) in the hands and feet is a symptom that occurs after a stroke and can limit daily activities, cause pain, and affect your ability to move.
While there have been reports of about 4% to 42% post-stroke spasticity, the numbers vary, and the more I read the references, the more diverse the reports I see (incidence of spasticity, as noted earlier). , may get old).
Since spasms don't occur after all strokes, I vaguely think whether it does or not depends on where and how much the brain is damaged.
In the 3 to 5 years since becoming an occupational therapist, I learned that the putamen is the part of the brain most involved in spastic development. When I did, I thought, "I might have cramps," so I started doing an initial assessment.
However, in addition to putamen bleeding, I have been responsible for many patients with post-stroke spasticity.
While reading various papers, I discovered that there are many other brain regions involved in spasticity.
Based on this, I want to write about the part of the brain that is involved in the occurrence of limb stiffness (spasm).
Location and size of brain damage
RI et al (2020) reported that involvement of the middle cerebral artery region, including the pyramidal tract, was frequently associated with spasticity (30.8%).
Regarding the prediction of spasticity, they concluded that it is possible to predict spasticity after stroke if the lesion is larger than 3 cm and the lesion is located in the middle cerebral artery region.
In addition, they noted that the development of spasticity could be predicted when the lesion extended into the pyramidal tract and internal capsule in the middle cerebral artery region. 
Source: Predicting the location and size of post-stroke spasms
Above is an MRI of a lesion in the middle cerebral artery region.
relationship with the putamen
Numerous studies have confirmed that the putamen is the brain region associated with spasticity.
Cheung et al (2016) reported that the putamen is the most common site of brain injury in patients with spasticity.
Toledo et al (2022) reported that hemiparesis and spasticity are affected by damage to the lateral sulcus, pericortical and subcortical areas, and the putamen.
Brain regions associated with upper extremity spasms
Lee et al (2019) reported that the brain regions involved in upper extremity spasticity are
□ Corona radiata
□ Curb the hind legs
□ thalamus
□ Putamen
□ Premotor cortex
□ Island
and many more.
Brain regions associated with lower extremity spasms
Lee et al (2019) reported that the brain regions associated with lower extremity spasticity are
□ Corona radiata
□ thalamus
□ Putamen
□ caudate nucleus
□ Outer packaging
□ Curb the hind legs
and many more.
At the end
This time, I wrote about the brain regions involved in the development of limb stiffness (spasms).
When I'm in charge of a patient, I want to do a thorough MRI.
Citations/references
1) S RI et al. SITE and SIZE OF LESION PRECICT POST-STROKE SPASTICITY: A RETROSPECTIVE MAGNETIC RESONANCE IMAGING STUDY. J Rehabil Med 2020; 52: jrm00065
2) Cheung et al.: Lesion characteristics of individuals with upper extremity spasticity after stroke. Neurorehabilitation and Neural Repair 2016, Vol. 30(1) 63-70
https://journals.sagepub.com/doi/pdf/10.1177/1545968315585357
3) Toledo et al. Shared and unique voxel-based lesion-symptom mapping for spasticity and dyskinesia of the hemiplegic upper extremity. Scientific Reports (2021)
https://www.nature.com/articles/s41598-022-14359-8.pdf
4) Lee KB, Hong BY, Kim JS, Sul B, Yoon SC, Ji EK, et al. (2019) Which brain injuries produce spasticity? An observational study of 45 stroke patients. PLoS ONE 14(1): e0210038
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6345431/pdf/pone.0210038.pdf
☆*:.｡.Thank you for reading to the end. :*☆
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This article was reprinted on September 6 , 2022 on Aoi Hashima's blog " Stroke Rehabilitation Longevity Consultation Center " .