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Updated: May 21, 2026

Determining the Functional Status of the Corticospinal Tract Within One Week of Stroke

Determining the Functional Status of the Corticospinal Tract Within One Week of Stroke

Published on: February 22, 2020

Relationships between functional and structural corticospinal tract integrity and walking post stroke.

Gowri Jayaram¹, Charlotte J Stagg, Patrick Esser

¹Department of Biomedical Engineering, Johns Hopkins University School of Medicine, 720 Rutland Avenue, Baltimore, MD 21205, USA. gjayara4@jhmi.edu

Clinical Neurophysiology : Official Journal of the International Federation of Clinical Neurophysiology

|June 22, 2012

Summary

Greater ipsilesional corticospinal tract (CST) damage and contralesional motor cortex connectivity correlate with worse lower limb function after stroke. These findings may guide personalized stroke rehabilitation strategies.

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Published on: February 19, 2019

Area of Science:

Neuroscience
Rehabilitation Medicine
Biomedical Engineering

Background:

Stroke recovery heavily relies on corticospinal tract (CST) integrity for upper limb function.
The relationship between CST integrity and lower limb function post-stroke is less understood.
Assessing lower limb motor control is crucial for patient mobility and quality of life.

Purpose of the Study:

To investigate the association between walking impairment and the structural/functional integrity of the CST in chronic stroke patients.
To determine if lower limb functional connectivity and CST structural integrity predict walking ability.

Main Methods:

Utilized transcranial magnetic stimulation (TMS) and electromyography (EMG) to measure lower limb motor evoked potentials.
Calculated the functional connectivity ratio (FCR) from ipsilateral and contralateral motor cortex outputs to the vastus lateralis.
Assessed CST structural integrity using diffusion tensor MRI (DT-MRI) to measure fractional anisotropy (FA) asymmetry.

Main Results:

The FCR of the paretic leg showed a correlation with walking impairment; increased ipsilateral connectivity was linked to slower walking speeds.
Asymmetrical FA values, indicating reduced structural integrity of the lesioned CST, correlated with greater walking impairment.
A strong positive correlation was observed between FCR and FA asymmetry.

Conclusions:

Greater ipsilesional CST structural damage and increased functional connectivity from the contralesional motor cortex to the paretic lower limb are associated with more severe walking impairment.
Structural and functional CST damage measures can inform the selection of tailored therapeutic strategies for stroke survivors.