Changes in structural integrity are correlated with motor and functional recovery after post-stroke rehabilitation.
OBJECTIVE
Diffusion tensor imaging (DTI) studies indicate the structural integrity of the ipsilesional corticospinal tract (CST) and the transcallosal motor tract, which are closely linked to stroke recovery. However, the individual contribution of these 2 fibers on different levels of outcomes remains unclear. Here, we used DTI tractography to investigate whether structural changes of the ipsilesional CST and the transcallosal motor tracts associate with motor and functional recovery after stroke rehabilitation.


METHODS
Ten participants with post-acute stroke underwent the Fugl-Meyer Assessment (FMA), the Wolf Motor Function Test (WMFT), the Functional Independence Measure (FIM), and DTI before and after bilateral robotic training.


RESULTS
All participants had marked improvements in motor performance, functional use of the affected arm, and independence in daily activities. Increased fractional anisotropy (FA) in the ipsilesional CST and the transcallosal motor tracts was noted from pre-treatment to the end of treatment. Participants with higher pre-to-post differences in FA values of the transcallosal motor tracts had greater gains in the WMFT and the FIM scores. A greater improvement on the FMA was coupled with increased FA changes along the ipsilesional CST.


CONCLUSIONS
These findings suggest 2 different structural indicators for post-stroke recovery separately at the impairment-based and function-based levels.
School of Occupational Therapy, College of Medicine, National Taiwan University, Taipei, Taiwan.
Yang-teng
YT
Fan
School of Occupational Therapy, College of Medicine, National Taiwan University, Taipei, Taiwan.|Division of Occupational Therapy, Department of Physical Medicine and Rehabilitation, National Taiwan University Hospital, Taipei, Taiwan.
Keh-chung
KC
Lin
Department of Imaging Physics, Division of Diagnostic Imaging, The University of Texas MD Anderson Cancer Center, Houston, TX, USA.
Ho-ling
HL
Liu
MRI Center, Chang Gung Memorial Hospital, Taoyuan, Taiwan.
Yao-liang
YL
Chen
Department of Occupational Therapy and Graduate Institute of Behavioral Sciences, College of Medicine, Chang Gung University, Taoyuan, Taiwan.|Healthy Aging Research Center, Chang Gung University, Taoyuan, Taiwan.
Ching-yi
CY
Wu
D000203:Activities of Daily Living; D000328:Adult; D016880:Anisotropy; D001132:Arm / Q000503:physiopathology; D001921:Brain / Q000473:pathology* / Q000503:physiopathology; D056324:Diffusion Tensor Imaging; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D009043:Motor Activity / Q000502:physiology; D026201:Musculoskeletal Manipulations / Q000295:instrumentation / Q000379:methods; D009434:Neural Pathways / Q000473:pathology / Q000503:physiopathology; D020127:Recovery of Function / Q000502:physiology; D012371:Robotics; D012720:Severity of Illness Index; D020521:Stroke / Q000473:pathology* / Q000503:physiopathology; D000071939:Stroke Rehabilitation; D016896:Treatment Outcome
Diffusion tensor imaging; corticospinal tract; motor recovery; rehabilitation; stroke; transcallosal motor tracts