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Motor tract integrity predicts walking recovery: A diffusion MRI study in subacute stroke
Julie Soulard1, Coline Huber1, Sebastien Baillieul1
1From the Université Grenoble Alpes (J.S., A.T., F.R., A.B.B., N.V., A.J.), AGEIS, Faculté de Médecine; Stroke Unit (J.S., A.T.), Neurologie, Centre Hospitalier Universitaire Grenoble Alpes (CHUGA); Unité IRM 3T-Recherche-UMS IRMaGe-CHUGA (C.H., A.K., A.J.); IRMaGe-Inserm US-017 (C.H., A.K.), CNRS UMS-3552, UGA, Grenoble; Neuroradiologie-IRM-Pôle Imagerie-CHUGA (A.K.); Centre Hospitalier Métropole Savoie (C.H.), Chambéry; Laboratoire HP2 (S.B.), UGA; Pôle thorax et vaisseaux, CHUGA; Pôle Recherche (A.J.), CHUGA, Grenoble; and Institut Universitaire de France (N.V.), Paris, France.
Fractional anisotropy (FA) of motor tracts like the corticospinal tract (CST) and cerebellar pathways can predict walking recovery after stroke. These white matter integrity measures offer valuable biomarkers for stroke rehabilitation outcomes.
Area of Science:
- Neuroscience
- Radiology
- Rehabilitation Medicine
Background:
- Stroke significantly impairs motor function, particularly walking.
- Identifying reliable biomarkers for predicting walking recovery is crucial for personalized rehabilitation strategies.
- Motor tract integrity, measurable via diffusion MRI, is a potential indicator of functional recovery.
Purpose of the Study:
- To identify candidate biomarkers for walking recovery in subacute stroke patients.
- To assess the relationship between motor tract integrity (using fractional anisotropy - FA) and walking recovery.
- To determine if motor tract integrity predicts improvements in walking scores.
Main Methods:
- A longitudinal study of 29 subacute ischemic stroke patients assessed walking scores (WS) over 2 years.
- Baseline FA measures of corticospinal tract (CST) and alternative motor pathways were derived from diffusion MRI.
- Generalized linear mixed models (GLMM) and correlation tests were used to analyze the data.
Main Results:
- Walking scores significantly improved over time, plateauing around 6 months post-stroke.
- WS correlated significantly with FA of the ipsilesional CST (i-CST), contralesional CST (c-CST), ipsilesional cortico-reticulospinal pathway (i-CRP), and bilateral cerebellar peduncles.
- FA measures from i-CST, i-CRP, and contralesional superior cerebellar peduncle (c-SCP) predicted walking recovery, explaining 80.5% of the variance.
Conclusions:
- Ipsilesional CST and alternative motor tracts (i-CRP, c-SCP) are candidate biomarkers for walking recovery.
- The superior cerebellar peduncle's role in walk recovery may involve cerebellar nuclei projections.
- White matter tracts within subcortical motor networks significantly contribute to walking recovery in stroke patients.
