Prediction of motor outcomes and activities of daily living function using diffusion tensor tractography in acute hemiparetic stroke patients

Abstract

[Purpose] The efficacy of diffusion tensor imaging in the prediction of motor outcomes and activities of daily living function remains unclear. We evaluated the most appropriate diffusion tensor parameters and methodology to determine whether the region of interest- or tractography-based method was more useful for predicting motor outcomes and activities of daily living function in stroke patients. [Subjects and Methods] Diffusion tensor imaging data within 10 days after stroke onset were collected and analyzed for 25 patients. The corticospinal tract was analyzed. Fractional anisotropy, number of fibers, and apparent diffusion coefficient were used as diffusion tensor parameters. Motor outcomes and activities of daily living function were evaluated on the same day as diffusion tensor imaging and at 1 month post-onset. [Results] The fractional anisotropy value of the affected corticospinal tract significantly correlated with the motor outcome and activities of daily living function within 10 days post-onset and at 1 month post-onset. Tthere were no significant correlations between other diffusion tensor parameters and motor outcomes or activities of daily living function. [Conclusion] The fractional anisotropy value of the affected corticospinal tract obtained using the tractography-based method was useful for predicting motor outcomes and activities of daily living function in stroke patients.

Structural connectome disruption at baseline predicts 6-months post-stroke outcome

“…Despite the many studies in predicting long‐term motor and language outcomes, there have been few studies analyzing the relationship between imaging biomarkers of the connectome measures of functions that influence overall cognitive and physical activities that determine an individual's daily quality of life, apart from specific motor or language abilities. One of the few studies we did find identified significant correlations between baseline FA in the CST with 1‐month Barthel Index ( r = 0.72, R 2 = 0.51) and Functional Independence Measure ( r = 0.71, R 2 = 0.50) [Imura et al, ]. In another study, voxel‐based lesion‐symptom mapping was performed to identify areas that were important in post‐stroke recovery of general ability [Cheng et al, ].…”

“…Accurate clinical prognoses are critical for policy makers and physicians to develop effective rehabilitation plans and for patients and their caregivers to plan for the future. Imaging biomarkers, in particular those of the structural connectome, have increasingly played an important role in predictions of chronic post‐stroke outcomes [Auriat et al, ; Crofts et al, ; Imura et al, ; Johansen‐Berg et al, ; Mukherjee, ; Venkatasubramanian et al, ], see Grefkes and Fink, [] for a review. The connectome, or map of structural and functional connections in the brain, has become commonplace in the neuroscience literature, starting with work by Sporns et al [].…”

“…In particular, measures of both local and remote white matter connectome disruption in stroke have been shown to predict motor [Puig et al, 2013], language [Hope et al, 2013] and cognitive recovery [Warren et al, 2014]. However, few quantitative imagingbased studies have focused on broader measures of activities that are likely related to distributed networks within the brain and that affect quality of life, such as general cognition, basic mobility, and daily activities [Cheng et al, 2014;Imura et al, 2015].…”

Proliferation of Bilateral Nerve Fibers Following Thalamic Infarction Contributes to Neurological Function Recovery: A Diffusion Tensor Imaging (DTI) Study

“…Previous studies using animal models have shown that synaptic plasticity and axonal growth are associated with increases in FA in recovered brain regions after stroke [ 31 , 32 ]. In addition, other DTI studies have shown that a decreased FA accompanied with an unchanged MD in CST can indicate degeneration of white matter at early stages of stroke [ 33 , 34 ], and the degree of FA decrease in CST can be used to predict motor outcome of patients [ 35 – 37 ]. Previous studies also showed that FA was increased in ipsilesional CST after stroke, indicating nerve fiber regeneration in CST [ 2 , 7 – 9 ].…”

Acute changes in diffusion tensor-derived metrics and its correlation with the motor outcome in gliomas adjacent to the corticospinal tract

“…A relationship between decreased anisotropic diffusivity and worse motor outcome has been described. [ 17 , 18 , 35 , 44 ]…”