Impact of corticofugal fibre involvement in subcortical stroke.
OBJECTIVE
To correlate motor deficit with involvement of corticofugal fibres in patients with subcortical stroke. The descending motor corticofugal fibres originate from the primary motor cortex (M1), dorsal and ventral premotor area (PMdv) and supplementary motor area (SMA).


METHODS
Retrospective study.


METHODS
Single tertiary teaching hospital.


METHODS
57 patients (57% men) with subcortical infarcts on MRI (2009-2011) were included. The mean age was 64.3±14.4 years.


METHODS
None.


METHODS
National Institute of Health Stroke Scale subscores for arm and leg motor deficit at 90 days.


RESULTS
An area under the receiver operating characteristics curve (AUC) for the volume of overlap with infarct (and M1/PMdv/SMA fibres) and motor outcome was calculated. The AUC for the association with arm motor deficit from M1 fibres involvement was 0.80 (95% CI 0.66 to 0.94), PMdv was 0.76 (95% CI 0.61 to 0.91) and SMA was 0.73 (95% CI 0.58 to 0.88). The AUC for leg motor deficit from M1 fibres involvement was 0.69 (95% CI 0.52 to 0.85), PMdv was 0.67 (95% CI 0.50 to 0.85), SMA was 0.66 (95% CI 0.48 to 0.84).


CONCLUSIONS
Following subcortical stroke, the correlations between involvement of the corticofugal fibres for upper and lower limbs motor deficit were variable. A poor motor outcome was not universal following subcortical stroke.
Stroke Unit, Monash Medical Centre, Melbourne, Victoria, Australia.
Thanh G
TG
Phan
Sanne
S
van der Voort
Jian
J
Chen
Richard
R
Beare
Henry
H
Ma
Benjamin
B
Clissold
John
J
Ly
Emma
E
Foster
Eleanor
E
Thong
Velandai
V
Srikanth
Rehabilitation Medicine; Stroke Medicine