Stronger prediction of motor recovery and outcome post-stroke by cortico-spinal tract integrity than functional connectivity
| Autor: | Gordon L. Shulman, Lenny Ramsey, Maurizio Corbetta, Leanne Y. Lin, Jennifer Rengachary, Joshua S. Shimony, Nicholas V. Metcalf |
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| Rok vydání: | 2018 |
| Předmět: |
Male
Central Nervous System 0301 basic medicine Motor Disorders lcsh:Medicine Social Sciences Pathology and Laboratory Medicine Vascular Medicine Nervous System Diagnostic Radiology 0302 clinical medicine Sociology Materials Physics Medicine and Health Sciences Prospective Studies lcsh:Science Prospective cohort study Microstructure Stroke Cerebral Ischemia Brain Mapping Multidisciplinary Radiology and Imaging Physics Middle Aged Magnetic Resonance Imaging Diffusion Tensor Imaging medicine.anatomical_structure Spinal Cord Neurology Physical Sciences Female Analysis of variance Anatomy medicine.symptom Research Article Adult medicine.medical_specialty Imaging Techniques Cerebrovascular Diseases Brain Morphometry Materials Science Neuroimaging Research and Analysis Methods Education White matter Lesion 03 medical and health sciences Signs and Symptoms Physical medicine and rehabilitation Diagnostic Medicine Fractional anisotropy medicine Humans Educational Attainment Aged Ischemic Stroke business.industry lcsh:R Biology and Life Sciences Recovery of Function medicine.disease 030104 developmental biology Lesions lcsh:Q business 030217 neurology & neurosurgery Neuroscience Diffusion MRI |
| Zdroj: | PLoS ONE PLoS ONE, Vol 13, Iss 8, p e0202504 (2018) |
| ISSN: | 1932-6203 |
| DOI: | 10.1371/journal.pone.0202504 |
| Popis: | Objectives To examine longitudinal changes in structural and functional connectivity post-stroke in patients with motor impairment, and define their importance for recovery and outcome at 12 months. Methods First-time stroke patients (N = 31) were studied at 1–2 weeks, 3 months, and 12 months post-injury with a validated motor battery and resting-state fMRI to measure inter-hemispheric functional connectivity (FC). Fractional anisotropy (FA) of the cortico-spinal tract (CST) was derived from diffusion tensor imaging as a measure of white matter organization. ANOVAs were used to test for changes in FC, FA, and motor performance scores over time, and regression analysis related motor outcome to clinical and neuroimaging variables. Results FA of the ipsilesional CST improved significantly from 3 to 12 months and was strongly correlated with motor performance. FA improved even in the absence of direct damage to the CST. Inter-hemispheric FC also improved over time, but did not correlate with motor performance at 12 months. Clinical variables (early motor score, education level, and age) predicted 80.4% of the variation of motor outcome, and FA increased the predictability to 84.6%. FC did not contribute to the prediction of motor outcome. Conclusions Stroke causes changes to the CST microstructure that can account for behavioral variability even in the absence of demonstrable lesion. Ipsilesional CST undergoes remodeling post-stroke, even past the three-month window when most of the motor recovery happens. FA of the CST, but not inter-hemispheric FC, can improve to the prediction of motor outcome based on early motor scores. |
| Databáze: | OpenAIRE |
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