The relation between motor function of stroke patients and diffusion tensor imaging findings for the corticospinal tract

Jang, Sung Ho; Kim, Kyoung; Kim, Seong Ho; Son, Su Min; Jang, Woo Hyuk; Kwon, Hyeok Gyu

doi:10.1016/j.neulet.2014.04.044

Cited by 52 publications

(59 citation statements)

References 36 publications

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“…4 All cross-sectional studies, using FA metrics (either regional FA or FA ratios between identical regions of interest in the affected and nonaffected hemispheres) agree that a decrease in FA at the level of the internal capsule, pons, or cerebral peduncles at 1 month after the event or later correlates with motor impairment in the chronic stage. [5][6][7][8][9] Tractography in those chronic cases indeed demonstrates a reduction of the tract volume, which may be interpreted as atrophy secondary to anterograde degeneration. 10,11 These metrics of PT integrity also seem to better correlate with motor impairment than lesion size alone 12 or task-based fMRI motor network activity 13 but are highly correlated with functional resting-state connectivity.…”

Section: Pyramidal Tract Integrity In Chronic Strokementioning

confidence: 98%

Structural and Resting-State Brain Connectivity of Motor Networks After Stroke

Thiel

Vahdat

2015

Stroke

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Section: Pyramidal Tract Integrity In Chronic Strokementioning

confidence: 98%

Structural and Resting-State Brain Connectivity of Motor Networks After Stroke

Thiel

Vahdat

2015

Stroke

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“…Using electromyography study, we could rule out the possibility of peripheral neuropathy. The contralateral CST is mandatory for the execution of the finger extensor, for which this patient showed nearly complete weakness (1/5), therefore, the precise evaluation of the state of the CST was mandatory in order to rule out the possibility of injury of the contralateral CST [4,5,21]. In addition, the state of the CFTs from the secondary motor area should also be evaluated in order to rule out the possibility of limb-kinetic apraxia [6,[22][23][24].…”

Section: Discussionmentioning

confidence: 99%

“…For a correct diagnosis of conversion disorder with motor weakness, the possibility of injury of the neural tracts for motor execution, especially the corticospinal tract (CST), and the corticofugal tract (CFT) from the secondary motor area for motor planning, should be ruled out [4][5][6][7]. Diffusion tensor tractography (DTT) provides a three-dimensional evaluation of the integrity and pathway of the injured CST or CFTs from the secondary motor area, while transcranial magnetic stimulation (TMS) can distinguish between the CST and non-CST, and estimates the amount of the CST by analyzing the characteristics of the motor evoked potential (MEP) [8,9].…”

Section: Introductionmentioning

confidence: 99%

Diagnosis of Conversion Disorder Using Diffusion Tensor Tractography and Transcranial Magnetic Stimulation in a Patient with Mild Traumatic Brain Injury

Jang

Seo

2019

Diagnostics

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We report on a patient with mild traumatic brain injury (TBI) who was diagnosed with conversion disorder for severe weakness of an arm, which was demonstrated using diffusion tensor tractography (DTT) and transcranial magnetic stimulation (TMS). A 23-year-old right-handed female suffered from head trauma resulting from a pedestrian car accident. She underwent rehabilitative management for memory impairment and central pain. At 14 months after onset, she complained of severe weakness of her right arm, which was detected in the morning after sleeping (right shoulder abductor: 3/5, elbow flexor: 3/5, wrist extensor: 1/5, finger flexor: 1/5, and finger extensor: 1/5). Electromyography study for peripheral neuropathy performed at 2 weeks after onset of weakness showed no abnormality. On a 14-month DTT configuration, the integrities of the left corticospinal tract (CST), supplementary motor area-corticofugal tract (SMA-CFT), and dorsal premotor cortex (dPMC)-CFT were well-preserved. Significant differences were not observed for the fractional anisotropy (FA), mean diffusivity (MD), and tract volume (TV) values of the CST, SMA-CFT, and dPMC-CFT in both hemispheres between the patient and ten right-handed age- and sex-matched normal subjects (p > 0.05). On a 14-month TMS study, MEPs obtained at the right abductor pollicis brevis muscle showed no abnormality. Using DTT and TMS, conversion disorder was demonstrated in a patient with mild TBI, who showed severe weakness of an arm. Our results suggest the usefulness of an evaluation of the CST and CFTs from the secondary motor areas using DTT, and the CST using TMS for patients who complain of motor weakness due to conversion disorder.

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“…Then these imaging indicators were correlated to function outcome as prediction markers. It has been found certain correlations between the changes of speci c ber bundles and functional outcomes, such as aphasia [6], neglect [7], paralysis [8] and etc. Besides of the command of motor function by CST, other brain areas involving movement control are still fuzzy.…”

Section: Introductionmentioning

confidence: 99%

Pattern of white matter degeneration in remote brain areas from the basal ganglion lesion of ischemic stroke patients with motor impairment

Cao¹,

Wang²,

Chen

et al. 2020

Preprint

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Abstract Background Diffusion tensor imaging (DTI) studies have revealed distinct white matter characteristic of brain following diseases. Beyond the lesion-symptom mapping, recent studies have demonstrate extensive structural and functional alterations of remote areas to local lesions caused by stroke in the brain. Here, we investigated the influences further from a global level by multivariate pattern analysis (MVPA) and network-based statistic (NBS). Methods Ten ischemic stroke patients with basal ganglia lesion and motor dysfunction and eleven demographically matched adults underwent brain Magnetic Resonance Imaging scans. DTI data was processed to obtain fractional anisotropy (FA) map and MVPA was used to explore brain regions that play an important role in classification based on FA map. White matter (WM) structural network was constructed by the deterministic fiber tracking approach according to the Automated Anatomical Labeling (AAL) atlas. NBS was used to explore differences of structural network between groups. Results MVPA applied to FA images correctly identified stroke patients with a statistically significant accuracy of 100% (P ≤ 0.001). Compared with the controls, the patients showed an FA reduction in the perilesional basal ganglia and brainstem, with a few in bilateral frontal lobes. Using NBS, we found the significant decreased FA-weighted WM subnetwork in stroke patients. Conclusions We identified some patterns of WM degeneration in the affected brain areas remote from the ischemic lesion, revealed the abnormal topological organization of WM network in stroke patients, which may be helpful for understanding of the neural mechanism of stroke sequela.

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The relation between motor function of stroke patients and diffusion tensor imaging findings for the corticospinal tract

Cited by 52 publications

References 36 publications

Structural and Resting-State Brain Connectivity of Motor Networks After Stroke

Structural and Resting-State Brain Connectivity of Motor Networks After Stroke

Diagnosis of Conversion Disorder Using Diffusion Tensor Tractography and Transcranial Magnetic Stimulation in a Patient with Mild Traumatic Brain Injury

Pattern of white matter degeneration in remote brain areas from the basal ganglion lesion of ischemic stroke patients with motor impairment

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