Integrity of the Inferior Cerebellar Peduncle Correlates with Ambulatory Function after Hemorrhagic Stroke

Cerebro-cerebellar connectivity plays a critical role in motor recovery after stroke; however, the underlying mechanism of walking recovery is unclear. The dorsal spinocerebellar pathway has been suggested as a biomarker of poststroke ambulatory function. We aimed to explore the association between ambulatory function and the dorsal spinocerebellar pathway's integrity after intracerebral hemorrhage (ICH).

Twenty-seven patients with ICH who were admitted for inpatient rehabilitation during the subacute phase of stroke and 27 age-matched healthy controls were included retrospectively. Ambulatory function was assessed using the Berg Balance Scale and Mobility score. We measured the fractional anisotropy (FA) values of the corticospinal tract (CST) and inferior cerebellar peduncle (ICP) as the final route of the dorsal spinocerebellar pathway. The FA laterality indices, representing the degree of degeneration, were calculated. A Spearman correlation analysis and multivariate linear regression models were used to determine the associations between the FA laterality indices and ambulatory function.

An FA reduction was found in both the ipsilesional CST and contralesional ICP of the patients. The ICP FA laterality index exhibited a moderate correlation with ambulatory function (Berg Balance Scale, ρ_BBS=0.589; Mobility score, ρ_MS=0.619). On dividing the patient group into the moderate (mRS 3, 4) and severe disability (mRS 5) groups, a stronger correlation was found (ρ_BBS=0.777, ρ_MS=0.856, moderate disability; ρ_BBS=0.732, ρ_MS=0.797, severe disability). The ICP FA laterality index and age were independently associated with the Mobility score (R²=0.525).

ICP degeneration occurs after ICH, and its degree is associated with ambulatory function after ICH.