Prediction of Motor Recovery in Patients with Basal Ganglia Hemorrhage Using Diffusion Tensor Imaging

Abstract

Predicting prognosis in patients with basal ganglia hemorrhage is difficult. This study aimed to investigate the usefulness of diffusion tensor imaging in predicting motor outcome after basal ganglia hemorrhage. A total of 12 patients with putaminal hemorrhage were included in the study (aged 50 ± 12 years), 8 patients were male (aged 46 ± 11 years) and 4 were female (aged 59 ± 9 years). We performed diffusion tensor imaging and measured clinical outcome at baseline (pre) and 3 weeks (post1), 3 months (post2), and 6 months (post3) after the initial treatment. In the affected side of the brain, the mean fractional anisotropy (FA) value on pons was significantly higher in the good outcome group than that in the poor outcome group at pre (p = 0.004) and post3 (p = 0.025). Pearson correlation analysis showed that mean FA value at pre significantly correlated with the sum of the Brunnstrom motor recovery stage scores at post3 (R = 0.8, p = 0.002). Change in the FA ratio on diffusion tractography can predict motor recovery after hemorrhagic stroke.

Exploring the Structural Plasticity Mechanism of Corticospinal Tract during Stroke Rehabilitation Based Automated Fiber Quantification Tractography

“…In addition, the application of FA is relatively more extensive. 39 In this study, we found that the AD and FA values were consistent, and both were significantly correlated with motor function, suggesting that these 2 indicators may be useful and potentially more effectively reflect the neuroplasticity of the CST during stroke rehabilitation.…”

“…There were time-effect statistical differences in the FA values (31-43 and 73-85; P < .05, FWE correction). Multiple comparisons suggested statistical differences between the FA values at T1 and T2, T1 and T4, and T3 and T4; there were higher FA values for the middle and lower segments (33)(34)(35)(36)(37)(38)(39)(40) at T1 than at T2, middle and upper segments (74-85) at T4 than at T1, and the middle and lower segments (1-48) at T4 than at T3. In addition, there were no statistical differences between T1 and T3, T2, and T3 (Figure 3).…”

Diffusion Tensor Imaging as a Prognostic Tool for Recovery in Acute and Hyperacute Stroke

“…One study does did provide information regarding field strength [ 30 ]. With regards to the number of directions, three studies used 6 directions (two in 1.5 T [ 34 , 35 ] and one in 3.0 T [ 36 ]), eight studies used 12 directions (four in 1.5 T [ 37 , 38 , 39 ] and four in 3.0 T [ 40 , 41 , 42 , 43 ]), three studies used 15 directions (two in 1.5 T [ 44 , 45 ] and one in 3.0 T [ 23 ]), three studies used 16 directions (one in 1.5 T [ 46 ] and two in 3.0 T [ 24 , 47 ]), one study in 1.5 T used 20 directions [ 31 ], one study in 3.0 T used 25 directions [ 48 ], eight studies used 30 directions (two in 1.5 T [ 49 , 50 ] and six in 3.0 T [ 18 , 29 , 33 , 51 , 52 , 53 ]), three studies in 1.5 T used 32 directions [ 54 , 55 , 56 ], one study in 3.0 T used 55 directions [ 57 ], and seven studies in 3.0 T used 64 directions [ 25 , 26 , 27 , 32 , 58 , 59 , 60 ]). Six studies did not provide information regarding diffusion directions.…”

“…In the good recovery group, mean FA on day 3 was significantly higher than in the poor recovery group and this value in the pathological side could predict motor recovery with sensitivity of 100% and a specificity of 77.8%. Similarly, Min and colleagues [ 48 ] studied 12 putaminal hemorrhage patients with DTI and clinical assessment within day 1 and 3 weeks, 3 months, and 6 months after the initial treatment and found that mean FA at the level of the pons in the affected side on day 1 and on 6 months was higher in the good outcome group than in the poor outcome group. They also reported significant association between the initial mean FA value and the sum of Brunnstrom motor recovery stage scores at 6 months.…”