Neural substrates of lower extremity motor, balance, and gait function after supratentorial stroke using voxel-based lesion symptom mapping

Moon, Hyun Im; Pyun, Sung Bom; Tae, Woo Suk; Kwon, Hee Kyu

doi:10.1007/s00234-016-1672-3

Cited by 21 publications

(23 citation statements)

References 30 publications

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“…Previous history of stroke and stroke recurrence may cause a culmination of deficits related to gait and impaired motor function arising from other brain lesions [2, 38]. Higher education was correlated with less disability, which is consistent with a study reported in India [39].…”

Section: Discussionsupporting

confidence: 84%

The Disability Rate of 5-Year Post-Stroke and Its Correlation Factors: A National Survey in China

et al. 2016

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Few studies on long-term functional outcome have been conducted in post-stroke patients in China. The objective of this study was to conduct a nationwide survey in China to investigate the 5-year prevalence of post-stroke disability and its correlation factors. A total of 893 patients with ischemic stroke were included. Demographic, clinical and neuro-imaging information were collected with standardized instruments that assessed stroke severity, depression, cognitive impairment, stroke recurrence and physical disability. Disability was assessed with the modified Ranking Score (mRS), of which a cutoff score ≥2 indicates disability. Statistical analysis included chi-square tests, two independent samples t-tests, Mann-Whitney U test and multiple logistic regression analysis. The frequency of disability in this study population was 45%. Multivariate analyses revealed that older age, lower education level, previous history of stroke, stroke severity at admission, depression, cognitive impairment at 3 months, and stroke recurrence within 5 years follow up were all significantly associated with post-stroke disability. The disability rate in 5-year post-stroke was high in Chinese patients. Treatment of depression, secondary prevention of stroke and rehabilitation may benefit disabled patients with stroke in China.

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Section: Discussionsupporting

confidence: 84%

The Disability Rate of 5-Year Post-Stroke and Its Correlation Factors: A National Survey in China

et al. 2016

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“…Knowledge of the association between stroke lesion and walking outcome is important to target rehabilitation goals after stroke. [ 13 ] Unlike previous studies using the clinical categorization of gait with the clinical evaluation of lower extremity function, [ 1 , 9 , 14 ] we used 3DMA to assess walking characteristics in detail. The corona radiata was a common region for spatiotemporal and kinematic parameters.…”

Section: Discussionmentioning

confidence: 99%

“…Most previous studies have reported that corticospinal pathway injury correlates with poorer upper extremity motor function in post-stroke patients, [ 7 , 19 ] but not with gait function. [ 6 , 8 , 14 ] The bilateral connection in the lower legs may reinnervate in 2 ways, either by connecting with ipsilesional fibers or by connecting with contralesional fibers, and this process may result in compensatory gait pattern after injury of the corona radiata and posterior limb of the internal capsule. The better knee flexion in the swing phase was one of the compensatory motions in the lesioned group, which connects with longer stride length and increased cadence (Table 3 ).…”

Section: Discussionmentioning

confidence: 99%

Brain mapping for long-term recovery of gait after supratentorial stroke

Kim

Kyeong

Hee³

et al. 2018

Medicine

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The recovery of independent gait after stroke is a main goal of patients and understanding the relationship between brain lesions and the recovery of gait can help physicians set viable rehabilitation plans. Our study investigated the association between variables of gait parameters and brain lesions.Fifty poststroke patients with a mean age of 67.5 ± 1.3 years and an average duration after onset of 62.2 ± 7.9 months were included. Three-dimensional gait analysis and magnetic resonance imaging were conducted for all patients. Twelve quantified gait parameters of temporal-spatial, kinematic, and kinetic data were used. To correlate gait parameters with specific brain lesions, we used a voxel-based lesion symptom mapping analysis. Statistical significance was set to an uncorrected P value <.005 and cluster size >10 voxels.Based on the location of a brain lesion, the following results were obtained: The posterior limb of the internal capsule was significantly associated with gait speed and increased knee extension in the stance phase. The hippocampus and frontal lobe were significantly associated with cadence. The proximal corona radiata was significantly associated with stride length and affected the hip maximal extension angle in the stance phase. The paracentral lobule was significantly associated with the affected knee maximal flexion angle in the swing phase and with the affected ankle maximal dorsiflexion angle in the stance phase. The frontal lobe, thalamus, and the lentiform nucleus were associated with kinetic gait parameters.Cortical, proximal white matter, and learning-related and motor-related areas are mainly associated with one's walking ability after stroke.

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“…Injury of the posterior corona radiata and posterior limb of the internal capsule may affect motor recovery and functional outcomes (Chen, Tang, Chen, Chung, & Wong, ). However, specific brain lesions influencing gait recovery have not been uncovered (Moon et al., ). In this study, white matter, such as the corona radiata and internal capsule, apparently affected the recovery of gait throughout the entire observation period, from onset to 6 months after stroke.…”

Section: Discussionmentioning

confidence: 99%

“…Our previous study showed the caudate nucleus was related to motor recovery in the lower limbs (Lee, Kim, Hong, & Lim, ). Another recent study failed to reveal specific lesion locations with regard to balance and gait function (Moon, Pyun, Tae, & Kwon, ). Previous researches for Parkinson's disease, s dorsal striatum has been known as a gait pattern generator (Gilat et al., ; Peterson, Pickett, Duncan, Perlmutter, & Earhart, ; Snijders et al., ).…”

Section: Introductionmentioning

confidence: 99%

Brain lesions affecting gait recovery in stroke patients

et al. 2017

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ObjectivesGait recovery is an important goal in stroke patients. Several studies have sought to uncover relationships between specific brain lesions and the recovery of gait, but the effects of specific brain lesions on gait remain unclear. Thus, we investigated the effects of stroke lesions on gait recovery in stroke patients.Materials and MethodsIn total, 30 subjects with stroke were assessed in a retrograde longitudinal observational study. To assess gait function, the functional ambulation category (FAC) was tested four times: initially (within 2 weeks) and 1, 3, and 6 months after the onset of the stroke. Brain lesions were analyzed via overlap, subtraction, and voxel‐based lesion symptom mapping (VLSM).ResultsAmbulation with FAC improved significantly with time. Subtraction analysis showed that involvement of the corona radiata, internal capsule, globus pallidus, and putamen were associated with poor recovery of gait throughout 6 months after onset. The caudate nucleus did influence poor recovery of gait at 6 months after onset. VLSM revealed that corona radiata, internal capsule, globus pallidus, putamen and cingulum were related with poor recovery of gait at 3 months after onset. Corona radiata, internal capsule, globus pallidus, putamen, primary motor cortex, and caudate nucleus were related with poor recovery of gait at 6 months after onset.ConclusionResults identified several important brain lesions for gait recovery in patients with stroke. These results may be useful for planning rehabilitation strategies for gait and understanding the prognosis of gait in stroke patients.

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Neural substrates of lower extremity motor, balance, and gait function after supratentorial stroke using voxel-based lesion symptom mapping

Cited by 21 publications

References 30 publications

The Disability Rate of 5-Year Post-Stroke and Its Correlation Factors: A National Survey in China

The Disability Rate of 5-Year Post-Stroke and Its Correlation Factors: A National Survey in China

Brain mapping for long-term recovery of gait after supratentorial stroke

Brain lesions affecting gait recovery in stroke patients

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