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Updated: Feb 23, 2026
Determining the Functional Status of the Corticospinal Tract Within One Week of Stroke
Published on: February 22, 2020
Interactions Between the Corticospinal Tract and Premotor-Motor Pathways for Residual Motor Output After Stroke
Robert Schulz1, Eunhee Park1, Jungsoo Lee1
1From the Department of Neurology, University Medical Center Hamburg-Eppendorf, Germany (R.S.); Department of Physical and Rehabilitation Medicine, Center for Prevention and Rehabilitation, Heart Vascular Stroke Institute, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea (J.L., W.H.C., Y.-H.K.); Department of Physical and Rehabilitation Medicine, Kyungpook National University Medical Center, Daegu, Republic of Korea (E.P.); Department of Health Sciences and Technology, Department of Medical Device Management & Research, SAIHST, Sungkyunkwan University, Seoul, Republic of Korea (J.L., A.L., Y.-H.K.); Defitech Chair of Clinical Neuroengineering, Brain Mind Institute and Centre of Neuroprosthetics (CNP), Swiss Federal Institute of Technology (EPFL), Geneva, Switzerland (F.C.H.); Defitech Chair of Clinical Neuroengineering, Brain Mind Institute and Centre of Neuroprosthetics (CNP), Swiss Federal Institute of Technology (EPFL Valais), CRR (Clinique Romande de Réadaptation), Sion, Switzerland (F.C.H.); and Department of Clinical Neurosciences, Geneva University Hospital, Switzerland (F.C.H.).
Background And Purpose:
Brain imaging has continuously enhanced our understanding how different brain networks contribute to motor recovery after stroke. However, the present models are still incomplete and do not fit for every patient. The interaction between the degree of damage of the corticospinal tract (CST) and of corticocortical motor connections, that is, the influence of the microstructural state of one connection on the importance of another has been largely neglected.
Methods:
Applying diffusion-weighted imaging and probabilistic tractography, we investigated cross-network interactions between the integrity of ipsilesional CST and ipsilesional corticocortical motor pathways for variance in residual motor outcome in 53 patients with subacute stroke.
Results:
The main finding was a significant interaction between the CST and corticocortical connections between the primary motor and ventral premotor cortex in relation to residual motor output. More specifically, the data indicate that the microstructural state of the connection primary motor-ventral premotor cortex plays only a role in patients with significant damage to the CST. In patients with slightly affected CST, this connection did not explain a relevant amount of variance in motor outcome.
Conclusions:
The present data show that patients with stroke with different degree of CST disruption differ in their dependency on structural premotor-motor connections for residual motor output. This finding might have important implications for future research on recovery prediction models and on responses to treatment strategies.
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