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Usefulness of voxel-based lesion mapping for predicting motor recovery in subjects with basal ganglia hemorrhage: A preliminary study with 2 case reports.

 Dae Hyun Kim  ;  Sunghyon Kyeong  ;  Yoona Cho  ;  Tae-min Jung  ;  Sung Jun Ahn  ;  Yoon Ghil Park 
 MEDICINE, Vol.95(23) : 3838, 2016 
Journal Title
Issue Date
Adult ; Basal Ganglia Hemorrhage/diagnosis* ; Basal Ganglia Hemorrhage/physiopathology ; Brain Mapping/methods* ; Diffusion Tensor Imaging/methods* ; Evoked Potentials, Motor/physiology ; Follow-Up Studies ; Humans ; Male ; Middle Aged ; Motor Activity/physiology* ; Pyramidal Tracts/diagnostic imaging* ; Pyramidal Tracts/physiopathology ; Recovery of Function/physiology*
basal ganglia hemorrhage ; cerebral hemorrhage ; diffusion tensor imaging ; motor-evoked potentials ; prognosis ; stroke
It is important to estimate motor recovery in the early phase after stroke. Many studies have demonstrated that both diffusion tensor tractography (DTT) and motor-evoked potentials (MEP) are valuable predictors of motor recovery, but these modalities do not directly reflect the status of the injured gray matter. We report on 2 subjects with basal ganglia hemorrhage who showed similar DTT and MEP findings, but had markedly different clinical outcomes. Specifically, Subject 1 showed no improvement in motor function, whereas Subject 2 exhibited substantial improvement 7 weeks after onset. To determine if differences in gray matter might lend insight into these different outcomes, we analyzed gray matter lesions of the 2 subjects using a novel voxel-based lesion mapping method. The lesion of Subject 1 mainly included the putamen, thalamus, and Heschl's gyri, indicating extension of the hemorrhage in the posterior direction. In contrast, the lesion of Subject 2 mainly included the putamen, insula, and pallidum, indicating that the hemorrhage extended anterior laterally. These differential findings suggest that voxel-based gray matter lesion mapping may help to predict differential motor recovery in subjects with basal ganglia hemorrhage with similar DTT and MEP findings.
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1. College of Medicine (의과대학) > BioMedical Science Institute (의생명과학부) > 1. Journal Papers
1. College of Medicine (의과대학) > Dept. of Neurology (신경과학교실) > 1. Journal Papers
1. College of Medicine (의과대학) > Dept. of Rehabilitation Medicine (재활의학교실) > 1. Journal Papers
1. College of Medicine (의과대학) > Dept. of Radiology (영상의학교실) > 1. Journal Papers
Yonsei Authors
Kyeong, Sung Hyon(경성현)
Park, Yoon Ghil(박윤길) ORCID logo https://orcid.org/0000-0001-9054-5300
Ahn, Sung Jun(안성준) ORCID logo https://orcid.org/0000-0003-0075-2432
Cho, Yu Na(조유나)
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