Corticoreticular Pathway in Post-Stroke Spasticity: A Diffusion Tensor Imaging Study

Abstract

One of the pathophysiologies of post-stroke spasticity (PSS) is the imbalance of the reticulospinal tract (RST) caused by injury to the corticoreticular pathway (CRP) after stroke. We investigated the relationship between injuries of the CRP and PSS using MR diffusion tensor imaging (DTI). The subjects were divided into spasticity and control groups. We measured the ipsilesional fractional anisotropy (iFA) and contralesional fractional anisotropy (cFA) values on the reticular formation (RF) of the CRP were on the DTI images. We carried out a retrospective analysis of 70 patients with ischemic stroke. The cFA values of CRP in the spasticity group were lower than those in the control group (p = 0.04). In the sub-ROI analysis of CRP, the iFA values of pontine RF were lower than the cFA values in both groups (p < 0.05). The cFA values of medullary RF in the spasticity group were lower than the iFA values within groups, and also lower than the cFA values in the control group (p < 0.05). This results showed the CRP injury and that imbalance of RST caused by CRP injury was associated with PSS. DTI analysis of CRP could provide imaging evidence for the pathophysiology of PSS.

Immediate and short-term effects of continuous theta burst transcranial magnetic stimulation over contralesional premotor area on post-stroke spasticity in patients with severe hemiplegia: Study protocol for a randomized controlled trial

“…DTI is used in diffusion-weighted gradients along 60 non-collinear directions and two non-diffusion-weighted volumes. Scanning parameters will include matrix size = 128 × 128, field of view = 230 × 230 mm 2 , TR = 5,800 ms, TE = 71 ms, flip angle = 180°, number of averages = 1, b value = 1,000 s/mm 2 , slice thickness = 4 mm, and voxel size = 1.7 × 1.7 × 4 mm 3 ( 47 ).…”

Personalized Approaches to Stroke: One Step Forward for Functional Recovery of Stroke Patients

“…Park et al [ 13 ] suggested that the alterations in the spinothalamic tract and superior thalamic radiation could be the pathogenesis of central post-stroke pain. Ko et al [ 14 ] reported that one of the pathophysiologies of post-stroke spasticity might be corticoreticular pathway injury. These insightful articles [ 11 , 12 , 13 , 14 ] could provide useful information about personalized rehabilitative strategies in stroke patients.…”

“…Ko et al [ 14 ] reported that one of the pathophysiologies of post-stroke spasticity might be corticoreticular pathway injury. These insightful articles [ 11 , 12 , 13 , 14 ] could provide useful information about personalized rehabilitative strategies in stroke patients.…”

“…Personalized medicine is a growing field in diagnosing, managing and predicting stroke and will enable clinicians to develop individually tailored care plans for stroke patients [ 3 , 6 , 7 , 22 ]. All papers published in this Special Issue will be able to contribute to the advance of personalized medicine in strokes [ 9 , 10 , 11 , 12 , 13 , 14 , 15 , 16 , 17 , 18 , 19 , 20 , 21 ]. The objective of this editorial is to stimulate any research on personalized medicine for the evaluation and treatment of stroke patients.…”

“…However, there are still many hurdles to overcome to reach personalized medicine for stroke patients. Through the papers published in this Special Issue [ 9 , 10 , 11 , 12 , 13 , 14 , 15 , 16 , 17 , 18 , 19 , 20 , 21 ], it was found that a number of factors must be considered, and a new and diverse approach was also required for personalized medicine. Therefore, a multidisciplinary approach and research are strongly encouraged for the personalized medicine of stroke treatment and rehabilitation.…”