Neuroimaging predictors of stroke outcome: implications for neurorehabilitation

Advances in neuroimaging have greatly improved our understanding of stroke not only in the acute, but also in the subacute and chronic stages of recovery. More recently developed magnetic resonance techniques such as diffusion and perfusion weighted imaging, as well as more traditional magnetic resonance and computed tomography studies allow clinicians to more accurately diagnosis stroke subtypes, optimize treatment, and predict prognosis. Although not widely utilized for clinical use, functional neuroimaging techniques have also been shown to be useful in terms of predicting prognosis and advancing our understanding of reorganization and recovery following stroke. Thus, neuroimaging in stroke may also be utilized to monitor response to both medical treatment as well as physical rehabilitation. The following is a review of current research relevant to the field of neuroimaging of stroke. We begin with a discussion of structural imaging techniques with the goal of familiarizing the reader with recent developments in this area. Next, the discussion moves to functional imaging, its role in advancing our understanding of neuronal reorganization and functional recovery following stroke, and its usefulness at predicting recovery. Finally, a brief discussion regarding the future of neuroimaging and its implications for stroke and stroke recovery is presented.