Usefulness of voxel-based lesion mapping for predicting motor recovery in subjects with basal ganglia hemorrhage: A preliminary study with 2 case reports.
It is important to estimate motor recovery in the early phase after stroke. Many studies have demonstrated that both diffusion tensor tractography (DTT) and motor-evoked potentials (MEP) are valuable predictors of motor recovery, but these modalities do not directly reflect the status of the injured gray matter. We report on 2 subjects with basal ganglia hemorrhage who showed similar DTT and MEP findings, but had markedly different clinical outcomes. Specifically, Subject 1 showed no improvement in motor function, whereas Subject 2 exhibited substantial improvement 7 weeks after onset. To determine if differences in gray matter might lend insight into these different outcomes, we analyzed gray matter lesions of the 2 subjects using a novel voxel-based lesion mapping method. The lesion of Subject 1 mainly included the putamen, thalamus, and Heschl's gyri, indicating extension of the hemorrhage in the posterior direction. In contrast, the lesion of Subject 2 mainly included the putamen, insula, and pallidum, indicating that the hemorrhage extended anterior laterally. These differential findings suggest that voxel-based gray matter lesion mapping may help to predict differential motor recovery in subjects with basal ganglia hemorrhage with similar DTT and MEP findings.
Department of Physical Medicine and Rehabilitation, Veterans Health Service Medical Center, Seoul Severance Biomedical Science Institute, Yonsei University College of Medicine Department of Rehabilitation Medicine and Rehabilitation Institute of Neuromuscular Disease, Yonsei University College of Medicine Department of Radiology, Yonsei University College of Medicine.
Dae Hyun
DH
Kim
Sunghyon
S
Kyeong
Yoona
Y
Cho
Tae-Min
TM
Jung
Sung Jun
SJ
Ahn
Yoon Ghil
YG
Park
D000328:Adult; D020145:Basal Ganglia Hemorrhage / Q000175:diagnosis* / Q000503:physiopathology; D001931:Brain Mapping / Q000379:methods*; D056324:Diffusion Tensor Imaging / Q000379:methods*; D019054:Evoked Potentials, Motor / Q000502:physiology; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D009043:Motor Activity / Q000502:physiology*; D011712:Pyramidal Tracts / Q000000981:diagnostic imaging* / Q000503:physiopathology; D020127:Recovery of Function / Q000502:physiology*