title: Relationship between diffusion tensor fractional anisotropy and long-term motor outcome in patients with hemiparesis after middle cerebral artery infarction.
abstract: BACKGROUND
  Magnetic resonance diffusion tensor fractional anisotropy (DTI-FA) is often used to characterize neural damage after stroke. Here we assessed the relationship between DTI-FA and long-term motor outcome in patients after middle cerebral artery (MCA) infarction.
  
  
  METHODS
  Fractional anisotropy (FA) maps were generated from diffusion tensor brain images obtained from 16 patients 14-18 days postinfarction, and tract-based spatial statistics (TBSS) analysis was applied. Regions of interest were set within the right and left corticospinal tracts, and mean FA values were extracted from individual TBSS data. Hemiparesis motor outcome was evaluated according to Brunnstrom stage (BRS: 1-6, severe-normal) for separate shoulder/elbow/forearm, hand, and lower extremity functions, as well as the motor component score of the Functional Independence Measure (FIM-motor: 13-91, null-full) 5-7 months after onset. Ratios between FA values in the affected and unaffected hemispheres (rFA) were assessed by BRS and FIM-motor scores.
  
  
  RESULTS
  rFA values were .636-.984 (median, .883) and BRS scores were 1-6 (median, 3) for shoulder/elbow/forearm, 2-6 (median, 3) for hand, and 3-6 (median, 5) for the lower extremities. FIM-motor scores were 51-90 (median, 75). Analysis revealed significant relationships between rFA and BRS data (correlation coefficient: .687 for shoulder/elbow/forearm, .579 for hand, and .623 for lower extremities) but no significance relationship between rFA and FIM-motor scores.
  
  
  CONCLUSIONS
  The results suggest that DTI-FA is applicable for predicting the long-term outcome of extremity functions after MCA infarction.
authors.affiliation: Department of Rehabilitation Medicine, Nishinomiya Kyoritsu Neurosurgical Hospital, Nishinomiya, Hyogo, Japan; Department of Physical Medicine and Rehabilitation, Hyogo College of Medicine, Nishinomiya, Hyogo, Japan. Electronic address: koyama.t@nk-hospital.or.jp.
authors.forename: Tetsuo
authors.initials: T
authors.lastname: Koyama
authors.affiliation: Department of Physical Medicine and Rehabilitation, Hyogo College of Medicine, Nishinomiya, Hyogo, Japan.
authors.forename: Kohei
authors.initials: K
authors.lastname: Marumoto
authors.affiliation: Department of Neurosurgery, Nishinomiya Kyoritsu Neurosurgical Hospital, Nishinomiya, Hyogo, Japan.
authors.forename: Hiroji
authors.initials: H
authors.lastname: Miyake
authors.affiliation: Department of Physical Medicine and Rehabilitation, Hyogo College of Medicine, Nishinomiya, Hyogo, Japan.
authors.forename: Kazuhisa
authors.initials: K
authors.lastname: Domen
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D038524:Diffusion Magnetic Resonance Imaging; D056324:Diffusion Tensor Imaging / Q000379:methods*; D005260:Female; D006801:Humans; D007091:Image Processing, Computer-Assisted; D020244:Infarction, Middle Cerebral Artery / Q000150:complications / Q000473:pathology*; D008297:Male; D008875:Middle Aged; D009069:Movement Disorders / Q000209:etiology / Q000473:pathology*; D010291:Paresis / Q000209:etiology / Q000473:pathology*; D016896:Treatment Outcome
keywords: Infarct; paresis; prognosis; recovery; stroke