scholarly journals Prediction of Upper Limb Motor Recovery after Subacute Ischemic Stroke Using Diffusion Tensor Imaging: A Systematic Review and Meta-Analysis

2016 ◽  
Vol 18 (1) ◽  
pp. 50-59 ◽  
Author(s):  
Pradeep Kumar ◽  
Prachi Kathuria ◽  
Pallavi Nair ◽  
Kameshwar Prasad
Keyword(s):  
Systematic Review ◽  
Ischemic Stroke ◽  
Diffusion Tensor Imaging ◽  
Upper Limb ◽  
Diffusion Tensor ◽  
Meta Analysis ◽  
Motor Recovery

scholarly journals Multimodal DTI-TMS assessment of the motor system in patients with chronic ischemic stroke

2019 ◽  
Author(s):  
M. Nazarova ◽  
S. Kulikova ◽  
M. Piradov ◽  
A. Limonova ◽  
L. Dobrynina ◽  
...  
Keyword(s):  
Ischemic Stroke ◽  
Upper Limb ◽  
Motor System ◽  
Diffusion Tensor ◽  
Motor Evoked Potentials ◽  
Statistical Tests ◽  
Motor Recovery ◽  
System Parameters ◽  
Tree Classifier ◽  
Recovery Groups

AbstractBackground and PurposeDespite the continuing efforts in multimodal assessment of the motor system after stroke, conclusive findings on the complementarity of functional and structural metrics of the corticospinal tract (CST) integrity and the role of the contralesional hemisphere are still missing. The aim of this work was to find the best combination of the motor system parameters, allowing classification of patients into three predefined groups of upper limb motor recovery.Methods35 chronic ischemic stroke patients (47 [26–66] y.o., 29 [6–58] months post-stroke) with only supratentorial lesion and unilateral upper extremity weakness were enrolled. Patients were divided into three groups depending on the upper limb motor recovery. Non-parametric statistical tests and regression analysis were used to investigate the relationships among structural and functional motor system parameters, probed by diffusion tensor imaging (DTI) and transcranial magnetic stimulation (TMS). In addition, stratification rules were tested, using a decision tree classifier to identify parameters explaining motor recovery.ResultsFractional anisotropy (FA) ratio in the internal capsule (IC) and absence/presence of motor evoked potentials (MEPs), were equally discriminative of the worst motor outcome group (96% accuracy). MEP presence diverged for two investigated hand muscles. Concurrently, for the three recovery groups’ classification, the best parameter combination was: IC FA ratio and Fréchet distance between the contralesional and ipsilesional CST FA profiles (91% accuracy). No other metrics had any additional value for patients’ classification.ConclusionsThis study demonstrates that IC FA ratio and MEPs absence are equally important markers for poor recovery. Importantly, we found that MEPs should be controlled in more than one hand muscle. Finally, we show that better separation between different motor recovery groups may be achieved when considering the whole CST FA profile.

Sign in / Sign up

Export Citation Format

Share Document