Correlation of Fractional Anisotropy With Motor Recovery in Patients With Stroke After Postacute Rehabilitation

Abstract

Objective To investigate the relationship between fractional anisotropy (FA), a suggested biomarker for tissue integrity, and motor recovery in stroke patients following post-acute rehabilitation. Design Retrospective study. Setting Acute rehabilitation hospital. Participants 43 subjects, 28 diagnosed with ischemic stroke, and 15 diagnosed with hemorrhagic stroke. The average age for subjects was (68±14 years). Interventions MRI and Diffusion Tensor Imaging (DTI) were conducted on all patients. Main Outcome Measure(s) This is a retrospective study. The admission and discharge motor sub-scores of the Functional Independence Measure (FIM) were obtained from medical records, and relative gain was calculated using the Montebello Rehabilitation Factor Score (MRFS). K-means cluster analysis (K=3) using both MRFS and gain of FIM motor sub-score (ΔFIM) was performed. ANOVA test was used to determine the difference in FA among the clusters. Spearman analysis was conducted to examine the relationship between FA, ΔFIM, and MRFS in each cluster. Results FA was significantly higher in the clusters of good and moderate recovery in the corticospinal tract (CST), peduncle, and posterior limb of the internal capsule (PLIC) bilaterally (all P<0.05) compared to the poor recovery group. Significant positive correlations were observed in multiple regions along CST between FA, ΔFIM, and MRFS in the clusters of good and moderate recovery, but not in the poor recovery group. Conclusion Our results showed an association between FA values within the corticospinal tract and motor recovery in stroke patients undergoing post-acute rehabilitation. This finding may help to identify novel targets for new interventions to promote stroke recovery.

Sensory tractography and robot‐quantified proprioception in hemiparetic children with perinatal stroke

“…This is consistent with our findings of greater fiber count in the non-dominant hemisphere of our controls. Studies from adult stroke do suggest that diffusion measures [Fan et al, 2015;Wen et al, 2016] and cortical volume [Gauthier et al, 2008] of corticospinal tract connectivity can be changed by intensive therapy. That our sample spanned a large age range allowed us to assess the maturation of the DCML pathways in children with perinatal stroke compared with typically developing children.…”

“…Through intensive therapy, there may be the potential to change the diffusion properties of the strokeaffected tracts toward more normal developmental curves, possibly improving sensorimotor function. Studies from adult stroke do suggest that diffusion measures [Fan et al, 2015;Wen et al, 2016] and cortical volume [Gauthier et al, 2008] of corticospinal tract connectivity can be changed by intensive therapy. Inclusion of such imaging measures of both motor and sensory tracts before and after intensive rehabilitation in hemiparetic children may carry such utility in the future.…”

Targeted Metabolomic Profiling Reveals Association Between Altered Amino Acids and Poor Functional Recovery After Stroke

“…FIM scale is widely used to evaluate the functional abilities of stroke patients undergoing rehabilitation (15,17). The scale includes 18 items graded on a 7-point ordinal scale, with a maximum total score of 126 where a lower score means less functional independence.…”

“…The total FIM scores were recorded at admission and discharge. The gain of the total FIM score, which is commonly used to evaluate functional recovery after stroke, was determined for every patient by calculating the difference of the total FIM score from admission to discharge (15,17).…”

“…Because length of stay and total FIM scores at admission varied considerably, Montebello Rehabilitation Factor Score (MRFS) efficiency was used to evaluate functional recovery after stroke (17,18). The MRFS evaluates relative gain, and this method depends on the validated FIM score.…”