Corticospinal Tract Integrity and Long-Term Hand Function Prognosis in Patients With Stroke

Abstract

Background: The restoration of hand function is an important goal for patients with stroke. This study investigated the relationship between corticospinal tract (CST) integrity and the functional status of the hand in patients with stroke 6 months after onset and evaluated which of the following values would be useful for predicting hand function: fiber number (FN), fractional anisotropy (FA) at the mid-pons, and FA at the pontomedullary junction. Methods: The present retrospective cross-sectional observational study assessed 44 patients with stroke who were able to walk without using a walking aid or orthosis. The final hand function results were classified into three groups: no recovery (unable to grasp), partial recovery (able to grasp, unable to oppose), and full recovery (able to grasp and oppose). All subjects underwent diffusion tensor imaging (DTI) at 6 months after stroke onset. Values for FA at the mid-pons and pontomedullary junction and CST FN were measured. The normalization ratio for FN and FA was calculated using the following formula: data for affected hand/data for non-affected hand. Results: The normalized FN, FA (mid-pons), and FA (pontomedullary junction) DTI values differed significantly. The FA (mid-pons) value for the full recovery group was higher than those for the other groups. The FA (mid-pons) value for the partial recovery group was higher than that for the no recovery group. The normalized FA (mid-pons) value differed significantly among all three groups. Conclusions: The present study showed that CST integrity (at 6 months after onset) in patients with chronic stroke was related to functional hand status. In addition, the mid-pons FA value was more predictive of functional restoration of the hand than the FN or FA value at the pontomedullary junction. These results may be useful in predicting the functional restoration of the hand and understanding the functional prognosis of stroke.

Graded motor imagery training as a home exercise program for upper limb motor function in patients with chronic stroke

“…Many researchers have investigated for uncovering culprit lesion related to upper limb function or establishing the therapeutic methods for recovery of the upper limb. [ 8 , 20 , 23 – 25 ] According to a previous study, the mental practice in chronic stroke patients provided significant reductions in affected arm impairment and significant increases in daily arm function. [ 13 ] The mirror therapy was introduced as 1 component of a home exercise program for chronic stroke patients with task-specific training.…”

Along‐tract statistics of neurite orientation dispersion and density imaging diffusion metrics to enhance MR tractography quantitative analysis in healthy controls and in patients with brain tumors

“…For each fascicle, ROI placement was determined a priori using ROIs either adopted from previous studies or based upon the anatomy of the fascicles as known from other tractography or anatomical studies, as follows. ROIs for AF, IFOF, and UF were placed as in Caverzasi et al (2015); ROIs for FAT were based on Sanvito et al (2020); ROIs for CING were based on the fascicle anatomy as known from Wakana, Jiang, Nagae‐Poetscher, van Zijl, and Mori (2004); seed‐ROI and target‐ROI for CST were placed as in Yoo et al (2019) and Castellano et al (2012), respectively; ROIs for OR were adapted from Chamberland et al (2017) and Chamberland, Tax, and Jones (2018) after lateral geniculate nucleus was identified as shown in Kitajima et al (2015). A more detailed report of anatomical landmarks and references used for ROI placement is displayed in Supplementary Table 1.…”

“…ROIs for FAT were based on Sanvito et al (2020); ROIs for CING were based on the fascicle anatomy as known from Wakana, Jiang, Nagae-Poetscher, van Zijl, and Mori (2004); seed-ROI and target-ROI for CST were placed as in Yoo et al (2019) and Castellano et al (2012), respectively; ROIs for OR were adapted from Chamberland et al (2017) and Chamberland, Tax, and Jones (2018) after lateral geniculate nucleus was identified as shown in Kitajima et al (2015). A more detailed report of anatomical landmarks and references used for ROI placement is displayed in Supplementary Table 1.…”

The effect of white matter integrity on functional outcome in central pontine demyelination

“…The relationship between DTI CST images and hand function has been evaluated several times8, 13,14,15,16 ) . Most reports have shown that damage to the CST is useful for predicting the restoration of motor function in patients with stroke13, 16,17,18 ) . Consistent with previous studies, the CST integrity reflected the functional status of the central pontine demyelination in our patients.…”