Association of Extrapyramidal Tracts' Integrity With Performance in Fine Motor Skills After Stroke
| Autor: | Hanna Braass, Christian Gerloff, Marlene Bönstrup, Robert Schulz, Benedikt M. Frey, Götz Thomalla, D Leander Rimmele, Lutz A. Krawinkel, Bastian Cheng |
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| Rok vydání: | 2018 |
| Předmět: |
0301 basic medicine
Adult Male medicine.medical_specialty Pyramidal Tracts Globus Pallidus 03 medical and health sciences 0302 clinical medicine Physical medicine and rehabilitation Fractional anisotropy Neural Pathways medicine Humans Stroke Motor skill Aged Extrapyramidal Tracts Advanced and Specialized Nursing Aged 80 and over business.industry Middle Aged medicine.disease White Matter Substantia Nigra 030104 developmental biology Globus pallidus medicine.anatomical_structure Diffusion Tensor Imaging Motor Skills Corticospinal tract Multivariate Analysis Extrapyramidal system Female Neurology (clinical) Cardiology and Cardiovascular Medicine business 030217 neurology & neurosurgery Diffusion MRI Tractography |
| Zdroj: | Stroke. 49(12) |
| ISSN: | 1524-4628 |
| Popis: | Background and Purpose— Tractography by diffusion tensor imaging has extended our knowledge on the contribution of damage to different pathways to residual motor function after stroke. Integrity of the corticospinal tract (CST), for example, has been identified to characterize and predict its course. Yet there is only scarce data that allow a judgment on the impact of extrapyramidal pathways between the basal ganglia on motor function poststroke. We aimed at studying their association with performance in fine motor skills after stroke. Methods— We performed probabilistic tractography and reconstructed nigro-pallidal tracts connecting substantia nigra and globus pallidus, as well as the CST in 26 healthy subjects. Resulting tracts were registered to the individual images of 20 patients 3 months after stroke, and their microstructural integrity was measured by fractional anisotropy. Clinical examination of the patients’ gross (grip force) and fine (nine-hole peg test) motor skills was performed 1 year after stroke. For assessment of factors influencing nine-hole peg test, we used a multivariate model. Results— Nigro-pallidal tracts were traceable in all participants, had no overlap to the CST and passed the nucleus subthalamicus. In stroke patients, nigro-pallidal tracts ipsilateral to the stroke lesion showed a significantly reduced fractional anisotropy (ratio, 0.96±0.02; P =0.021). One year after stroke, nine-hole peg test values were significantly slower for the affected hand, while grip force was comparable between both hands. Reduced integrity of the nigro-pallidal tracts was associated with worse performance in the nine-hole peg test ( P =0.040), as was reduced integrity of the CST ( P P Conclusions— Nigro-pallidal tracts with containing connections of the nucleus subthalamicus represent a relevant part of the extrapyramidal system and specifically contribute to residual fine motor skills after stroke beyond the well-known contribution of the CST. They may deliver supportive information for prediction of motor recovery after stroke. |
| Databáze: | OpenAIRE |
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