title: Prediction of upper extremity motor recovery after subacute intracerebral hemorrhage through diffusion tensor imaging: a systematic review and meta-analysis.
abstract: BACKGROUND
  Early assessment of the pyramidal tracts is important for intracerebral hemorrhage (ICH) patients in order to decide the optimal treatment or to assess appropriate rehabilitation strategies, and management of patient expectations and goals. The purpose of this study was to systematically review and summarize the current available literature on the value of Fractional Anisotropy (FA) parameter of the diffusion tensor imaging (DTI) in predicting upper extremity (UE) motor recovery after subacute ICH.
  
  
  METHODS
  PubMed, EMBASE, MEDLINE, Google Scholar, and Cochrane CENTRAL searches were conducted from 1 January 1950 to 31 March 2016 which were supplemented with relevant articles identified in the references. Pooled estimate using correlation between DTI parameter FA and UE motor recovery was done using comprehensive meta-analysis software.
  
  
  RESULTS
  Out of 97 citations, only eight studies met the criteria for inclusion in the systematic review and six studies were included in the meta-analysis. A random effects model revealed that DTI parameter FA is a significant predictor for UE motor recovery after subacute ICH (correlation coefficient = 0.56; 95 % confidence interval 0.44 to 0.65, P value <0.001). However, moderate heterogeneity was observed between the studies (Tau-squared = 0.28, I-squared = 70.3).
  
  
  CONCLUSIONS
  The studies reported so far on correlation between FA parameter of DTI and UE motor recovery in ICH patients are few with small sample sizes. This meta-analysis suggests a strong correlation between DTI parameter FA and UE motor recovery in ICH patients. Further well-designed prospective studies embedded with larger sample size are needed to confirm these findings.
authors.affiliation: Department of Neurology, Neurosciences Centre, All India Institute of Medical Sciences, Room No. 702, 7th Floor, Ansari Nagar, New Delhi, India. pradeepguptaneuro@gmail.com.
authors.forename: Pradeep
authors.initials: P
authors.lastname: Kumar
authors.affiliation: Department of Neurology, Neurosciences Centre, All India Institute of Medical Sciences, Room No. 702, 7th Floor, Ansari Nagar, New Delhi, India.
authors.forename: Arun Kumar
authors.initials: AK
authors.lastname: Yadav
authors.affiliation: Department of Neurology, Neurosciences Centre, All India Institute of Medical Sciences, Room No. 702, 7th Floor, Ansari Nagar, New Delhi, India.
authors.forename: Shubham
authors.initials: S
authors.lastname: Misra
authors.affiliation: Department of Neurology, Neurosciences Centre, All India Institute of Medical Sciences, Room No. 702, 7th Floor, Ansari Nagar, New Delhi, India.
authors.forename: Amit
authors.initials: A
authors.lastname: Kumar
authors.affiliation: Department of Neurology, Neurosciences Centre, All India Institute of Medical Sciences, Room No. 702, 7th Floor, Ansari Nagar, New Delhi, India.
authors.forename: Kamalesh
authors.initials: K
authors.lastname: Chakravarty
authors.affiliation: Department of Neurology, Neurosciences Centre, All India Institute of Medical Sciences, Room No. 702, 7th Floor, Ansari Nagar, New Delhi, India.
authors.forename: Kameshwar
authors.initials: K
authors.lastname: Prasad
mesh_terms: D000368:Aged; D015984:Causality; D002543:Cerebral Hemorrhage / Q000000981:diagnostic imaging* / Q000453:epidemiology*; D015897:Comorbidity; D056324:Diffusion Tensor Imaging / Q000379:methods / Q000706:statistics & numerical data*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009069:Movement Disorders / Q000000981:diagnostic imaging* / Q000453:epidemiology*; D015995:Prevalence; D011379:Prognosis; D020127:Recovery of Function; D015203:Reproducibility of Results; D012307:Risk Factors; D012680:Sensitivity and Specificity; D034941:Upper Extremity
keywords: Diffusion tensor imaging; Diffusion tensor tractography; Intracerebral hemorrhage; Prediction; Upper extremity recovery