Elsevier

NeuroImage: Clinical

Volume 4, 2014, Pages 201-208
NeuroImage: Clinical

Motor recovery and microstructural change in rubro-spinal tract in subcortical stroke

https://doi.org/10.1016/j.nicl.2013.12.003Get rights and content
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Highlights

  • Subcortical stroke patients showed motor hemiparesis followed by gradual recovery.

  • Lesion overlap was located with its center in the posterior limb of internal capsule.

  • Fractional anisotropy (FA) gradually increased in the red nucleus in three months.

  • FA in the red nucleus was positively correlated with recovery of motor paresis.

  • FA in the middle part of corpus callosum was also correlated with motor recovery.

Abstract

The mechanism of motor recovery after stroke may involve reorganization of the surviving networks. However, details of adaptive changes in structural connectivity are not well understood. Here, we show long-term changes in white matter microstructure that relate to motor recovery in stroke patients. We studied ten subcortical ischemic stroke patients who showed motor hemiparesis at the initial clinical examination and an infarcted lesion centered in the posterior limb of internal capsule of the unilateral hemisphere at the initial diffusion-weighted magnetic resonance imaging scan. The participants underwent serial diffusion tensor imaging and motor function assessments at three consecutive time points; within 2 weeks, and at 1 and 3 months after the onset. Fractional anisotropy (FA) was analyzed for regional differences between hemispheres and time points, as well as for correlation with motor recovery using a tract-based spatial statistics analysis. The results showed significantly increased FA in the red nucleus and dorsal pons in the ipsi-lesional side at 3 months, and significantly decreased FA in the ipsi-lesional internal capsule at all time points, and in the cerebral peduncle, corona radiata, and corpus callosum at 3 months. In the correlation analysis, FA values of clusters in the red nucleus, dorsal pons, midbody of corpus callosum, and cingulum were positively correlated with recovery of motor function. Our study suggests that changes in white matter microstructure in alternative descending motor tracts including the rubro-spinal pathway, and interhemispheric callosal connections may play a key role in compensating for motor impairment after subcortical stroke.

Abbreviations

CC
Corpus callosum
CP
Cerebral peduncle
CR
Corona radiata
DTI
Diffusion tensor imaging
EPT
Extrapyramidal tract
FA
Fractional Anisotropy
FMMS
Fugl-Meyer Motor Scale
PLIC
Posterior limb of internal capsule
PT
Pyramidal tract
TBSS
Tract-based spatial statistics

Keywords

Motor recovery
Subcortical stroke
Reorganization
Diffusion tensor image
Tract-based spatial statistics

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This is an open-access article distributed under the terms of the Creative Commons Attribution-NonCommercial-No Derivative Works License, which permits non-commercial use, distribution, and reproduction in any medium, provided the original author and source are credited.

1

Present addresses: Department of Neurology, Senri Chuo Hospital, Osaka, Japan.