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Longitudinal Structural and Functional Differences Between Proportional and Poor Motor Recovery After Stroke
Adrian G Guggisberg1,2, Pierre Nicolo1,2, Leonardo G Cohen3
11 Geneva University Hospital, Geneva, Switzerland.
Neurorehabilitation and Neural Repair
|November 14, 2017
Summary
Stroke recovery bifurcates into proportional (PROP) or poor (POOR) patterns. Initial corticospinal tract integrity and brain connectivity predict better motor function recovery and less white matter degradation post-stroke.
Area of Science:
- Neuroscience
- Neurology
- Rehabilitation Medicine
Background:
- Motor function recovery after stroke typically follows one of two patterns: proportional recovery (PROP) or poor recovery (POOR).
- Current rehabilitation strategies lack evidence for preventing poor recovery and promoting proportional recovery.
Purpose of the Study:
- To longitudinally and multimodally assess functional and structural brain changes associated with proportional recovery (PROP) after stroke.
- Identify neurobiological markers that differentiate between proportional and poor stroke recovery patterns.
Main Methods:
- Fugl-Meyer Assessments for upper extremity function and high-density electroencephalography (EEG) were used.
- Diffusion tensor imaging (DTI) was employed to assess white matter integrity.
- Assessments were conducted at two time points: 2-4 weeks (T0) and 3 months (T1) post-stroke onset in 63 patients.
Main Results:
- Confirmed two distinct recovery patterns: PROP and POOR.
- PROP patients exhibited greater corticospinal tract (CST) integrity and functional connectivity (FC) at T0, particularly between premotor and motor cortices.
- POOR patients showed degradation of white matter tracts between T0 and T1, unlike PROP patients. Initial CST integrity correlated with initial FC and reduced white matter degradation.
Conclusions:
- Initial corticospinal tract integrity, brain network plasticity, and reduced white matter atrophy are linked to clinical motor recovery after stroke.
- These findings highlight potential therapeutic targets for enhancing stroke motor recovery.
