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Determining the Functional Status of the Corticospinal Tract Within One Week of Stroke
Published on: February 22, 2020
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Extraction of corticospinal tract microstructural properties in chronic stroke
S J Feldman1, L A Boyd2, J L Neva3
1Graduate Program in Neuroscience, Faculty of Medicine, University of British Columbia, Vancouver BC, V6T 1Z3, Canada.
Journal of Neuroscience Methods
|March 10, 2018
Summary
Diffusion-weighted imaging (DWI) methods for corticospinal tract (CST) reconstruction impact results in chronic stroke. Fractional anisotropy (FA) best reflects motor function in severe stroke, highlighting the need for standardized DWI analysis.
Area of Science:
- Neuroimaging
- Stroke Rehabilitation
- Biomarker Discovery
Background:
- Diffusion-weighted imaging (DWI) provides insights into corticospinal tract (CST) integrity, crucial for understanding motor outcomes post-stroke.
- Accurate CST representation is vital for assessing upper limb impairment, particularly in severe chronic stroke cases.
- Current methods for CST reconstruction lack consensus, hindering reliable functional and impairment assessments.
Purpose of the Study:
- To compare various CST reconstruction techniques and their derived microstructural properties.
- To investigate the correlation between CST microstructural properties and motor function/impairment levels.
- To identify the most representative DWI metric for CST integrity in chronic stroke patients.
Main Methods:
- Fifteen individuals with mild-moderate and 15 with severe chronic stroke underwent DWI scans.
- Motor function and impairment assessments were conducted alongside DWI data acquisition.
- Multiple CST reconstruction methods were employed to analyze microstructural properties like fractional anisotropy (FA) and apparent diffusion coefficient (ADC).
Main Results:
- In severe chronic stroke, fractional anisotropy (FA) significantly correlated with motor impairment and function, unlike ADC or tract number.
- No significant differences in reconstruction methods or microstructural properties were observed in mild-moderate stroke cases.
- The choice of CST reconstruction method demonstrably influenced the assessment of microstructural integrity in severe stroke.
Conclusions:
- CST reconstruction methodology critically affects microstructural integrity assessment in severe chronic stroke.
- Fractional anisotropy (FA) appears to be the most reliable metric for indexing CST integrity and correlating with motor outcomes in this population.
- Standardizing DWI analysis for CST reconstruction is essential for consistent interpretation and enhanced biomarker utility in stroke recovery.
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