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Can the integrity of the corticospinal tract predict the long-term motor outcome in poststroke hemiplegic patients?

 Ae Ryoung Kim  ;  Dae Hyun Kim  ;  So Young Park  ;  Sunghyon Kyeong  ;  Yong Wook Kim  ;  Seung Koo Lee  ;  Deog Young Kim 
 Neuroreport, Vol.29(6) : 453-458, 2018 
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This study aimed to investigate the long-term motor outcome according to early diffusion tensor tractography findings for the affected corticospinal tract (CST) in poststroke hemiplegic patients. A total of 48 supratentorial subacute patients after stroke were enrolled, who had a brain MRI scan within 6 weeks from onset, and no stroke recurrence reported within the 2-year follow-up period. Diffusion tensor images were obtained and CSTs were reconstructed. The participants were classified into three groups: type A, the CST originating from the primary motor cortex was preserved around the lesion area; type B, the CST was similar to type A, except that the fiber originated from the area adjacent to the primary motor cortex; and type C, the CST was interrupted or not shown. Motor functions using Fugl-Meyer Motor Assessment (FMA), the Box and Block Test (BBT), and Functional Ambulation Category, and cognitive function using Mini-Mental Status Examination (MMSE) were measured at baseline and at 2 years from stroke onset. Changes in FMA and BBT were significantly different according to diffusion tensor tractography type at follow-up (P<0.05), but Functional Ambulation Category and Mini-Mental Status Examination were not. In post-hoc analysis, groups A and B showed greater significant improvements on the BBT and on the upper FMA subscale (shoulder/elbow, wrist, and hand) compared with group C (corrected P<0.05), but did not on lower FMA. This study showed the importance of CST integrity for stoke motor recovery. The early integrity of the CST may be useful in predicting long-term motor outcomes, specifically with motor recovery of the upper extremity and hand function.
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1. College of Medicine (의과대학) > BioMedical Science Institute (의생명과학부) > 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)
Kim, Deog Young(김덕용) ORCID logo https://orcid.org/0000-0001-7622-6311
Kim, Yong Wook(김용욱) ORCID logo https://orcid.org/0000-0002-5234-2454
Lee, Seung Koo(이승구) ORCID logo https://orcid.org/0000-0001-5646-4072
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