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Published on: August 14, 2019
Prediction of motor outcome based on diffusion tensor tractography findings in thalamic hemorrhage
Sung Ho Jang1, Byung Yeon Choi, Chul Hoon Chang
1Department of Physical Medicine and Rehabilitation, College of Medicine, Yeungnam University, Daemyungdong, Namku, Taegu, Republic of Korea.
Objectives:
Little is known about the usefulness of diffusion tensor tractography (DTT) findings of the corticospinal tract (CST) in terms of predicting motor outcome after thalamic hemorrhage. We investigated the predictive value of DTT for motor outcome in patients with thalamic hemorrhage.
Methods:
Twenty-one patients were recruited; DTTs were obtained within 7-30 d of thalamic hemorrhage. We determined fractional anisotropies (FAs), tract numbers, and tract lengths of CSTs and calculated affected CST versus unaffected CST ratios for each value. In addition, patients were classified into two groups; a DTT type A group, in which the CST was preserved around the hematoma, and a DTT type B group, in which the CST was interrupted. Six months after thalamic hemorrhage, motor functions of affected sides were evaluated using upper Motricity Index (MI), lower MI, total MI, the modified Brunnstrom classification (MBC) and functional ambulation category (FAC).
Results:
DTT parameters of CSTs, that is, FA ratios, tract number ratios and tract length ratios of affected/unaffected CSTs were found to be positively correlated with 6-month upper MIs, lower MIs, total MIs, MBCs and FACs. In addition, all motor function scores at 6 months after onset were higher in the DTT type A group than in the DTT type B group.
Conclusions:
Early DTT evaluation of CSTs appears to be useful for predicting motor outcomes of affected extremities at chronic stage in patients with thalamic hemorrhage.
