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Published on: August 27, 2020
Peri-infarct reorganization of motor function in patients with pontine infarct
Young Hwan Ahn1, Sung H You, Marilys Randolph
1Department of Neurosurgery, School of Medicine, Ajou University, Suwon, Republic of Korea.
Objectives:
Combined functional MRI (fMRI) and diffusion tensor tractography (DTT) imaging provides a powerful vehicle for the investigation of motor recovery mechanisms. Using this combined method, we investigated the motor recovery mechanism in patients with pontine infarct.
Design:
We evaluated six healthy control subjects and two patients with pontine infarct at 6 months from onset. fMRI was performed at 1.5 T with timed hand grasp-release movements. For DTT, we used each of the 32 noncollinear diffusion-sensitizing gradients. Three-dimensional reconstructions of the fiber tracts were obtained with FA <0.3, angle >45 degrees as termination criteria.
Results:
fMRI data revealed activation only in the contralateral primary sensorimotor cortex during movement of either hand. DTI findings from controls and the unaffected hemisphere of the patients showed that the corticospinal tract descended through the known corticospinal tract pathway. However, the tracts of the affected hemisphere in the patients were observed to pass along peri-infarct areas (patient 1: lateral, patient 2: posterior) in the pons.
Conclusions:
It seems that the peri-infarct areas compensate for corticospinal tract damage at the pons; this may be one mechanism of motor recovery for patients with pontine infarct.
Insights
Functional MRI and diffusion tensor tractography reveal that peri-infarct areas in the pons may aid motor recovery after pontine infarct by compensating for corticospinal tract damage.
Area of Science:
- Neuroimaging
- Neurology
- Rehabilitation Medicine
Background:
- Pontine infarcts can lead to significant motor deficits.
- Understanding motor recovery mechanisms is crucial for effective rehabilitation.
Purpose of the Study:
- To investigate motor recovery mechanisms in patients with pontine infarct using combined functional MRI (fMRI) and diffusion tensor tractography (DTT).
Main Methods:
- Evaluated six healthy controls and two patients with pontine infarct.
- Utilized fMRI with timed hand grasp-release movements.
- Employed DTT with 32 diffusion-sensitizing gradients and specific termination criteria for fiber tract reconstruction.
Main Results:
- fMRI showed contralateral primary sensorimotor cortex activation during hand movements.
- Controls and unaffected hemispheres displayed normal corticospinal tract (CST) pathways.
- In patients, affected hemisphere CSTs rerouted through peri-infarct areas in the pons.
Conclusions:
- Peri-infarct areas in the pons appear to compensate for CST damage.
- This compensation may represent a key mechanism for motor recovery in pontine infarct patients.
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