Evaluating the axonal injury and predicting the motor function recovery in supratentorial acute stroke patients

Purpose

This study aims to evaluate axonal injury in supratentorial acute stroke patients and predict motor function recovery.

Methods

A cross-sectional descriptive study was performed on 28 patients with supratentorial acute stroke. All patients underwent brain magnetic resonance imaging (MRI) at Bach Mai Hospital from September 2021 to August 2022. Diffuse tensor imaging (DTI) was conducted using a 3-Tesla MRI machine to evaluate the association between the corticospinal tract and infarct area. Therefore, axonal injury and motor function recovery levels could be predicted.

Results

Almost patients had no change in the signal of the axons, which did not pass through the infarct lesion (28.6%), and the signals strongly decreased in patients whose axons completely stayed inside the infarct lesion (32.1%). The fractional anisotropy (FA) and apparent diffusion coefficient (ADC) indices of the axons on the infarcted side were lower than those of axons on the contralateral side. The patient group, in which the axons did not pass through the infarct lesion or had no change in axonal signals, had a higher rate of better motor function recovery after 3 months than the other groups (39.3% and 25 %, respectively), whereas the axon group, in which the axons stayed completely inside the infarct lesion or had a remarkably decreased signal, had a very poor rate of recovery (32.1% and 39.3 %, respectively). The FA index of the axons on the infarct side in the poor recovery group was lower than that in the good recovery group. The ADC index did not differ between the groups.

Conclusion

MRI finding with axonal signal, location, and infarct side could significantly predict motor recovery after 3 months in acute stroke patients.