Prognosis of the Ipsilesional Corticospinal Tracts with Preserved Integrities at the Early Stage of Cerebral Infarction: Follow Up Diffusion Tensor Tractography Study

Abstract

This study examined the prognosis of the ipsilesional corticospinal tracts (CSTs) with preserved integrities at the early stage of cerebral infarction using follow-up diffusion tensor tractography (DTT). Thirty-one patients with a supratentorial infarction were recruited. DTT, Motricity Index (MI), modified Brunnstrom classification (MBC), and functional ambulation category (FAC) were performed twice at the early and chronic stages. The patients were classified into two groups based on the integrity of the ipsilesional CST on the second DTT: Group A (24 patients; 77.4%)—preserved integrity and Group B (7 patients; 22.6%)—disrupted integrity. No significant differences in MI, MBC, and FAC were observed between groups A and B at the first and second evaluations, except for FAC at the first evaluation (p > 0.05). MI, MBC, and FAC at the second evaluation were significantly higher than at the first evaluation in both groups A and B (p < 0.05). On the second DTT, one patient (4.2%) in group A showed a false-positive result, whereas five patients (71.4%) in group B had false-negative results. Approximately 20% of patients showed disruption of the ipsilesional CST at the chronic stage. However, the clinical outcomes in hand and gait functions were generally good. Careful interpretation considering the somatotopy of the ipsilesional CST is needed because of the high false-negative results on DTT at the chronic stage.

Protective effects of human urinary kallidinogenase against corticospinal tract damage in acute ischemic stroke patients

“…The integrity of the corticospinal tract is beneficial to the recovery of motor function in cerebral infarction patients with hemiplegia. Recently, the integrity of corticospinal tract preservation has been studied as a predictor of motor function recovery in the early stage of cerebral infarction [15,16]. Thus, it is plausible to hypothesize that HUK may play a protective role in the injured corticospinal tract of AIS patients and promote the recovery of motor function in the short term.…”