Neuroimaging Identifies Patients Most Likely to Respond to a Restorative Stroke Therapy

Cassidy, Jessica M.; Tran, George; Quinlan, Erin Burke; Cramer, Steven C.

doi:10.1161/strokeaha.117.018844

Cited by 50 publications

(71 citation statements)

References 40 publications

(55 reference statements)

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“…Our findings also indicated that tract/lesion overlap was not related either to performance on the proprioceptive or motor tasks. This is consistent with Cassidy et al () who investigated FA of the posterior limb of the internal capsule and motor recovery in a chronic stroke sample. Additionally, our findings are in agreement with Lindenberg et al () who reported that diffusivity changes were present in chronic stroke subjects with motor deficits even if the lesion did not directly overlap the tract.…”

Section: Discussionsupporting

confidence: 92%

“…Fractional anisotropy (FA) of the CST is considered a biomarker for predicting motor recovery after stroke (Boyd et al, ). Biomarkers, such as CST‐FA, are anticipated to one‐day guide treatment content and timing, as well as inform inclusion criteria for clinical trials (Boyd et al, ; Cassidy, Tran, Quinlan, & Cramer, ; Ward, ). The recommendation to include CST‐FA as a biomarker has largely resulted from two different types of studies.…”

Section: Introductionmentioning

confidence: 99%

“…content and timing, as well as inform inclusion criteria for clinical trials (Boyd et al, 2017;Cassidy, Tran, Quinlan, & Cramer, 2018;Ward, 2017). The recommendation to include CST-FA as a biomarker has largely resulted from two different types of studies.…”

mentioning

confidence: 99%

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Proprioception and motor performance after stroke: An examination of diffusion properties in sensory and motor pathways

Findlater

Mazerolle

Pike

et al. 2019

Human Brain Mapping

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Proprioceptive and motor impairments commonly occur after stroke. Relationships between corticospinal tract (CST) fractional anisotropy (FA) and motor recovery have been identified. However, the relationship between sensory tract microstructure and proprioceptive recovery remains unexplored. Using probabilistic tractography, we examined the relationship between diffusion metrics in three tracts known to contain proprioceptive information (a) dorsal‐column medial‐lemniscal (DCML), (b) postcentral gyrus to supramarginal gyrus (POCG‐SMG), (c) postcentral gyrus to Heschl's gyrus (POCG‐HG) and proprioception at 1 (n = 26) and 6 months (n = 19) poststroke. Proprioception was assessed using two robotic tasks. Motor performance was also assessed robotically and compared to CST diffusion metrics. At 1‐month poststroke, a nonsignificant relationship (r = −0.43, p = 0.05) was observed between DCML‐FA and proprioceptive impairment. A moderate relationship was identified between POCG‐SMG FA and POCG‐HG FA and proprioceptive impairment (r = −0.47, p = 0.001 and r = −0.51, p = 0.008, respectively). No relationships were significant at 6 months poststroke. Similar to previous studies, lower CST‐FA correlated with motor impairment at 1 month poststroke (r = −0.58, p = 0.002). While CST‐FA is considered a predictor of motor impairment, our findings suggest that the relationship between FA and tracts containing proprioceptive information is not as straightforward and highlights the importance of sensory association areas in proprioception.

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Section: Discussionsupporting

confidence: 92%

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Proprioception and motor performance after stroke: An examination of diffusion properties in sensory and motor pathways

Findlater

Mazerolle

Pike

et al. 2019

Human Brain Mapping

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“…In addition to evaluating FA, MD, AD, and RD, we also examined the reliability of the normalized tract integrity values (FA ratio and FA asymmetry) since these values are commonly related to measures of behavior in chronic stroke (Borich et al, ; Cassidy, Tran, Quinlan, & Cramer, ; Lindenberg et al, ; Stewart, Dewanjee, Shariff, & Cramer, ; Stewart et al, ; Stinear et al, ). FA ratio and FA asymmetry values were reliable across time (ICC = 0.82–0.98), with the mean values reflecting a relatively small difference between ipsilesional and contralesional CST.…”

Section: Discussionmentioning

confidence: 99%

Test–retest reliability and minimal detectable change of corticospinal tract integrity in chronic stroke

Lewis

Myers

Heiser

et al. 2020

Human Brain Mapping

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Diffusion tensor imaging (DTI) can be used to index white matter integrity of the corticospinal tract (CST) after stroke; however, the psychometric properties of DTIbased measures of white matter integrity are unknown. The purpose of this study was to examine test-retest reliability as determined by intraclass correlation coefficients (ICC) and calculate minimal detectable change (MDC) of DTI-based measures of CST integrity using three different approaches: a Cerebral Peduncle approach, a Probabilistic Tract approach, and a Tract Template approach. Eighteen participants with chronic stroke underwent DTI on the same magnetic resonance imaging scanner 4 days apart.For the Cerebral Peduncle approach, a researcher hand drew masks at the cerebral peduncle. For the Probabilistic Tract approach, tractography was seeded in motor areas of the cortex to the cerebral peduncle. For the Tract Template approach, a standard CST template was transformed into native space. For all approaches, the researcher performing analyses was blind to participant number and day of data collection. All three approaches had good to excellent test-retest reliability for fractional anisotropy (FA; ICCs >0.786). Mean diffusivity, axial diffusivity, and radial diffusivity were less reliable than FA. The ICC values were highest and MDC values were the smallest for the most automated approach (Tract Template), followed by the combined manual/automated approach (Probabilistic Tract) then the manual approach (Cerebral Peduncle). The results of this study may have implications for how DTI-based measures of CST integrity are used to define impairment, predict outcomes, and interpret change after stroke. K E Y W O R D S corticospinal tract, diffusion tensor imaging, fractional anisotropy, minimal detectable change, reliability, stroke

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“…We did not include lesion volume as a covariate in the hierarchical regression analyses since CST Injury and lesion volume are likely collinear. We selected CST Injury, rather than lesion volume, as a biomarker of the structural integrity of the motor system since the former is a better predictor of motor recovery after stroke than the latter 7 , 8 , 51 , 52 . We assessed the influence of each covariate separately given statistical power limitations with a small sample.…”

Section: Methodsmentioning

confidence: 99%

Variability in stroke motor outcome is explained by structural and functional integrity of the motor system

Lam

Binns

Honjo

et al. 2018

Sci Rep

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Biomarkers that represent the structural and functional integrity of the motor system enable us to better assess motor outcome post-stroke. The degree of overlap between the stroke lesion and corticospinal tract (CST Injury) is a measure of the structural integrity of the motor system, whereas the left-to-right motor cortex resting state connectivity (LM1-RM1 rs-connectivity) is a measure of its functional integrity. CST Injury and LM1-RM1 rs-connectivity each individually correlate with motor outcome post-stroke, but less is understood about the relationship between these biomarkers. Thus, this study investigates the relationship between CST Injury and LM1-RM1 rs-connectivity, individually and together, with motor outcome. Twenty-seven participants with upper limb motor deficits post-stroke completed motor assessments and underwent MRI at one time point. CST Injury and LM1-RM1 rs-connectivity were derived from T1-weighted and resting state functional MRI scans, respectively. We performed hierarchical multiple regression analyses to determine the contribution of each biomarker in explaining motor outcome. The interaction between CST Injury and LM1-RM1 rs-connectivity does not significantly contribute to the variability in motor outcome. However, inclusion of both CST Injury and LM1-RM1 rs-connectivity explains more variability in motor outcome, than either alone. We suggest both biomarkers provide distinct information about an individual’s motor outcome.

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Neuroimaging Identifies Patients Most Likely to Respond to a Restorative Stroke Therapy

Cited by 50 publications

References 40 publications

Proprioception and motor performance after stroke: An examination of diffusion properties in sensory and motor pathways

Proprioception and motor performance after stroke: An examination of diffusion properties in sensory and motor pathways

Test–retest reliability and minimal detectable change of corticospinal tract integrity in chronic stroke

Variability in stroke motor outcome is explained by structural and functional integrity of the motor system

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