Corticospinal Tract Injury Leads to Poor Motor Recovery Immediately After Ischemic Stroke

IF 2.3 4区医学 Q3 CLINICAL NEUROLOGY

Journal of Neuroimaging Pub Date : 2025-10-09 DOI:10.1111/jon.70095

Muhib Khan, Leo Gallagher, Laurel Packard, Jessica Parker, Dave Chesla, Gabe Heredia

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引用次数: 0

Abstract

Background and Purpose

Corticospinal tract (CST) integrity is an imaging biomarker for predicting upper extremity motor recovery, but data are limited in acute ischemic stroke patients. Our study aimed to assess the impact of CST disruption on upper extremity motor recovery after acute ischemic stroke.

Methods

We enrolled patients with upper extremity motor deficits within 7 days of stroke onset. Patients’ clinical status was assessed for the upper extremity Fugl–Meyer assessment motor component (UE-FM) within 7 days of stroke and at 15, 30, and 90 days. MRI with tractography was performed within 7 days of stroke. Diffusion tensor images (DTI) were processed to produce maps of fractional anisotropy (FA), apparent diffusion, axial, radial, and mean diffusivity. FA maps were used to assess CST asymmetry index (CST-AI). Fisher's exact tests for categorical variables, two-sample t-tests for normally distributed numerical data, and Wilcoxon rank sums for non-normally distributed numeric data were used.

Results

A total of 21 patients were enrolled in the study with a mean age of 66 (±14) years and median baseline upper extremity motor component score (UE-FM) of 42 (median) [range: 23, 53]. Baseline UE-FM was not predictive of a 10-point change at 90 days (p = 0.4469). CST-AI was predictive of recovery at 15 days (p = 0.0373), and axial diffusivity was predictive of recovery at 90 days (p = 0.0402). All other imaging variables did not predict recovery.

Conclusion

Our data suggest that upper extremity motor recovery after acute ischemic stroke is impacted by CST integrity. Further studies are needed to validate our findings.

Abstract Image

查看原文本刊更多论文

缺血性脑卒中后皮质脊髓束损伤导致运动恢复不良。

背景和目的：皮质脊髓束（CST）完整性是预测上肢运动恢复的影像学生物标志物，但在急性缺血性脑卒中患者中数据有限。我们的研究旨在评估CST中断对急性缺血性脑卒中后上肢运动恢复的影响。方法：我们招募了中风发作后7天内出现上肢运动障碍的患者。在中风后7天内以及15、30和90天对患者进行上肢Fugl-Meyer评估运动成分（UE-FM）的临床状态评估。脑卒中后7天内进行核磁共振与神经束造影。对扩散张量图像（DTI）进行处理，生成分数各向异性（FA）、表观扩散、轴向、径向和平均扩散率的图。FA图用于评估CST不对称指数（CST- ai）。分类变量使用Fisher精确检验，正态分布数值数据使用双样本t检验，非正态分布数值数据使用Wilcoxon秩和。结果：共有21例患者入组研究，平均年龄66（±14）岁，上肢运动成分评分（UE-FM）基线中位数为42（中位数）[范围：23,53]。基线UE-FM不能预测90天10点的变化（p = 0.4469）。CST-AI预测15天的恢复（p = 0.0373），轴向扩散率预测90天的恢复（p = 0.0402）。所有其他影像学指标均不能预测恢复。结论：我们的数据表明急性缺血性脑卒中后上肢运动恢复受到CST完整性的影响。需要进一步的研究来验证我们的发现。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Journal of Neuroimaging 医学-核医学

CiteScore

4.70

自引率

0.00%

发文量

117

审稿时长

6-12 weeks

期刊介绍： Start reading the Journal of Neuroimaging to learn the latest neurological imaging techniques. The peer-reviewed research is written in a practical clinical context, giving you the information you need on: MRI CT Carotid Ultrasound and TCD SPECT PET Endovascular Surgical Neuroradiology Functional MRI Xenon CT and other new and upcoming neuroscientific modalities.The Journal of Neuroimaging addresses the full spectrum of human nervous system disease, including stroke, neoplasia, degenerating and demyelinating disease, epilepsy, tumors, lesions, infectious disease, cerebral vascular arterial diseases, toxic-metabolic disease, psychoses, dementias, heredo-familial disease, and trauma.Offering original research, review articles, case reports, neuroimaging CPCs, and evaluations of instruments and technology relevant to the nervous system, the Journal of Neuroimaging focuses on useful clinical developments and applications, tested techniques and interpretations, patient care, diagnostics, and therapeutics. Start reading today!