title: Corticospinal tract change during motor recovery in patients with medulla infarct: a diffusion tensor imaging study.
abstract: Diffusion tensor imaging (DTI) and tractography (DTT) provide a powerful vehicle for investigating motor recovery mechanisms. However, little is known about these mechanisms in patients with medullary lesions. We used DTI and DTT to evaluate three patients presenting with motor deficits following unilateral medulla infarct. Patients were scanned three times during 1 month (within 7, 14, and 30 days after stroke onset). Fractional anisotropy (FA) values were measured in the medulla, cerebral peduncle, and internal capsule. The three-dimensional corticospinal tract (CST) was reconstructed using DTT. Patients 1 and 2 showed good motor recovery after 14 days, and the FA values of their affected CST were slightly decreased. DTTs demonstrated that the affected CST passed along periinfarct areas and that tract integrity was preserved in the medulla. Patient 3 had the most obvious decrease in FA values along the affected CST, with motor deficits of the right upper extremity after 30 days. The affected CST passed through the infarct and was disrupted in the medulla. In conclusion, DTI can detect the involvement and changes of the CST in patients with medulla infarct during motor recovery. The degree of degeneration and spared periinfarct CST compensation may be an important motor recovery mechanism.
authors: Department of Radiology, Xuanwu Hospital of Capital Medical University, Beijing 100053, China ; Beijing Key Laboratory of Magnetic Resonance Imaging and Brain Informatics, Beijing 100053, China.
authors: Dongdong
authors: 0000-0002-2517-8839
authors: D
authors: Rong
authors: Department of Radiology, Xuanwu Hospital of Capital Medical University, Beijing 100053, China ; Beijing Key Laboratory of Magnetic Resonance Imaging and Brain Informatics, Beijing 100053, China.
authors: Miao
authors: M
authors: Zhang
authors: Department of Neurology, Xuanwu Hospital of Capital Medical University, Beijing 100053, China.
authors: Qingfeng
authors: Q
authors: Ma
authors: Department of Radiology, Xuanwu Hospital of Capital Medical University, Beijing 100053, China ; Beijing Key Laboratory of Magnetic Resonance Imaging and Brain Informatics, Beijing 100053, China.
authors: Jie
authors: J
authors: Lu
authors: Department of Radiology, Xuanwu Hospital of Capital Medical University, Beijing 100053, China ; Beijing Key Laboratory of Magnetic Resonance Imaging and Brain Informatics, Beijing 100053, China.
authors: Kuncheng
authors: K
authors: Li
mesh_terms: D020526:Brain Stem Infarctions / Q000000981:diagnostic imaging / Q000503:physiopathology / Q000628:therapy; D056324:Diffusion Tensor Imaging / Q000379:methods*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008526:Medulla Oblongata / Q000000981:diagnostic imaging / Q000503:physiopathology; D008875:Middle Aged; D009043:Motor Activity; D011712:Pyramidal Tracts / Q000000981:diagnostic imaging / Q000503:physiopathology; D011859:Radiography; D020127:Recovery of Function