Cortico-Cerebellar Structural Connectivity Is Related to Residual Motor Output in Chronic Stroke.
Functional imaging studies have argued that interactions between cortical motor areas and the cerebellum are relevant for motor output and recovery processes after stroke. However, the impact of the underlying structural connections is poorly understood. To investigate this, diffusion-weighted brain imaging was conducted in 26 well-characterized chronic stroke patients (aged 63 ± 1.9 years, 18 males) with supratentorial ischemic lesions and 26 healthy participants. Probabilistic tractography was used to reconstruct reciprocal cortico-cerebellar tracts and to relate their microstructural integrity to residual motor functioning applying linear regression modeling. The main finding was a significant association between cortico-cerebellar structural connectivity and residual motor function, independent from the level of damage to the cortico-spinal tract. Specifically, white matter integrity of the cerebellar outflow tract, the dentato-thalamo-cortical tract, was positively related to both general motor output and fine motor skills. Additionally, the integrity of the descending cortico-ponto-cerebellar tract contributed to rather fine motor skills. A comparable structure-function relationship was not evident in the controls. The present study provides first tract-related structural data demonstrating a critical importance of distinct cortico-cerebellar connections for motor output after stroke.
BrainImaging and NeuroStimulation (BINS) Laboratory, Department of Neurology.
Robert
R
Schulz
BrainImaging and NeuroStimulation (BINS) Laboratory, Department of Neurology.
Benedikt M
BM
Frey
BrainImaging and NeuroStimulation (BINS) Laboratory, Department of Neurology.
Philipp
P
Koch
BrainImaging and NeuroStimulation (BINS) Laboratory, Department of Neurology.
Maximo
M
Zimerman
BrainImaging and NeuroStimulation (BINS) Laboratory, Department of Neurology.
Marlene
M
Bönstrup
BrainImaging and NeuroStimulation (BINS) Laboratory, Department of Neurology.
Jan
J
Feldheim
BrainImaging and NeuroStimulation (BINS) Laboratory, Department of Neurology.
Jan E
JE
Timmermann
Department of Medical Biometry and Epidemiology.
Gerhard
G
Schön
Clinical Stroke Imaging Laboratory, Department of Neurology, University Medical Center Hamburg-Eppendorf, 20246 Hamburg, Germany.
Bastian
B
Cheng
Clinical Stroke Imaging Laboratory, Department of Neurology, University Medical Center Hamburg-Eppendorf, 20246 Hamburg, Germany.
Götz
G
Thomalla
BrainImaging and NeuroStimulation (BINS) Laboratory, Department of Neurology.
Christian
C
Gerloff
BrainImaging and NeuroStimulation (BINS) Laboratory, Department of Neurology.
Friedhelm C
FC
Hummel
D000368:Aged; D009320:Atrial Natriuretic Factor; D002545:Brain Ischemia / Q000000981:diagnostic imaging / Q000503:physiopathology; D002531:Cerebellum / Q000000981:diagnostic imaging* / Q000503:physiopathology; D002540:Cerebral Cortex / Q000000981:diagnostic imaging* / Q000503:physiopathology; D002908:Chronic Disease; D038524:Diffusion Magnetic Resonance Imaging; D056324:Diffusion Tensor Imaging; D005260:Female; D006801:Humans; D016014:Linear Models; D008297:Male; D008875:Middle Aged; D009043:Motor Activity / Q000502:physiology; D009434:Neural Pathways / Q000000981:diagnostic imaging / Q000503:physiopathology; D020521:Stroke / Q000000981:diagnostic imaging* / Q000503:physiopathology*; D066127:White Matter / Q000000981:diagnostic imaging / Q000503:physiopathology
C472610:atrial natriuretic peptide, rat; D009320:Atrial Natriuretic Factor
cerebellum; cortico-ponto-cerebellar; dentato-thalamo-cortical; motor cortex; recovery