Somatotopic Organization of Motor Fibers in the Corona Radiata in Monoparetic Patients With Small Subcortical Infarct

Song, Young-Mok

doi:10.1161/strokeaha.106.480632

Cited by 38 publications

(31 citation statements)

References 7 publications

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“…These imply that there is no one-to-one correlation between stroke severity and NIHSS, leaving stroke researchers with a possible discordance that cannot be resolved without reference to imaging findings. Our results support previous studies [16,17,19] that highlighted the importance of lesion location affecting the neurological deficit of stroke patients. Again, this illustrates the usefulness of an image-based stroke database supplementing conventional alphanumeric databases in stroke research.…”

Section: Discussionsupporting

confidence: 92%

“…Based on published literature [16,17,18,19], we set up an a priori hypothesis: when lacunar stroke patients are divided into 2 groups based on a higher or lower admission NIHSS score, the locations of the composite lesions and/or infarct sizes would be different. We also tested if the 2 groups had any differences with regards to alphanumeric data, including demographic variables and risk factor variables.…”

Section: Methodsmentioning

confidence: 99%

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A New Image-Based Stroke Registry Containing Quantitative Magnetic Resonance Imaging Data

Kim

Park²,

Schellingerhout

et al. 2011

Cerebrovasc Dis

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Background: Conventional stroke registries contain alphanumeric text-based data on the clinical status of stroke patients, but this format captures imaging data in a very limited form. There is a need for a new type of stroke registry to capture both text- and image-based data. Methods and Results: We designed a next-generation stroke registry containing quantitative magnetic resonance imaging (MRI) data, ‘DUIH_SRegI’, developed a supporting software package, ‘Image_QNA’, and performed experiments to assess the feasibility and utility of the system. Image_QNA enabled the mapping of stroke-related lesions on MR onto a standard brain template and the storage of this extracted imaging data in a visual database. Interuser and intrauser variability of the lesion mapping procedure was low. We compared the results from the semi automatic lesion registration using Image_QNA with automatic lesion registration using SPM5 (Statistical Parametric Mapping version 5), a well-regarded standard neuroscience software package, in terms of lesion location, size and shape, and found Image_QNA to be superior. We assessed the clinical usefulness of an image-based registry by studying 47 consecutive patients with first-ever lacunar infarcts in the corona radiata. We used the enriched dataset comprised of both image-based and alphanumeric databases to show that diffusion MR lesions overlapped in a more posterolateral brain location for patients with high NIH Stroke Scale scores (≧4) than for patients with low scores (≤3). In April 2009, we launched the first prospective image-based acute (≤1 week) stroke registry at our institution. The registered data include high signal intensity ischemic lesions on diffusion, T₂-weighted, or fluid attenuation inversion recovery MRIs, and low signal intensity hemorrhagic lesions on gradient-echo MRIs. An interim analysis at 6 months showed that the time requirement for the lesion registration (183 consecutive patients, 3,226 MR slices with visible stroke-related lesions) was acceptable at about 1 h of labor per patient by a trained assistant with physician oversight. Conclusions: We have developed a novel image-based stroke registry, with database functions that allow the formulation and testing of intuitive, image-based hypotheses in a manner not easily achievable with conventional alphanumeric stroke registries.

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Section: Discussionsupporting

confidence: 92%

Section: Methodsmentioning

confidence: 99%

A New Image-Based Stroke Registry Containing Quantitative Magnetic Resonance Imaging Data

Kim

Park²,

Schellingerhout

et al. 2011

Cerebrovasc Dis

View full text Add to dashboard Cite

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“…Stroke studies have shown that lesions in the posterior half of the PVWM are associated with paresis and that the pattern of paresis corresponds with the somatotopic localization defined by DTT studies [1][2][3]. Our lesion maps are consistent with this localization.…”

Section: Discussionsupporting

confidence: 84%

“…It is well established that the primary cause of hemiparesis following hemispheric stroke is damage to the motor cortex or the white matter pathways in the centrum semiovale, periventricular white matter (PVWM), or the posterior limb of the internal capsule linking this cortex to the brain stem and spinal cord [1][2][3][4][5][6][7][8][9][10]. The centrum semiovale and posterior PVWM contain the corona radiata, which includes fibers originating in the motor cortex that continue ventrally to comprise the posterior limb of the internal capsule.…”

Section: Introductionmentioning

confidence: 99%

Mechanisms of arm paresis in middle cerebral artery distribution stroke: Pilot study

Hedna

Jain²,

Rabbani

et al. 2013

J Rehabil Res Dev

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Abstract-The development of effective neurobiological adjuvants to rehabilitation of paresis caused by stroke will depend on understanding mechanisms of paresis. Our objective was to determine the extent to which upper-limb (UL) paresis after nonlacunar ischemic middle cerebral artery (MCA) distribution stroke is caused by infarction of posterior periventricular white matter (PVWM), where corticospinal fibers serving movement descend, and caused by infarction of the arm-hand region of precentral gyrus (ahPCG). We conducted a blinded, retrospective analysis of computed tomography and magnetic resonance imaging from a convenience sample of 64 prospectively evaluated subjects with UL paresis resulting from MCA distribution stroke. Of the subjects, 96.5% had PVWM involvement while 53% had minimal or no ahPCG involvement. Even in subjects with no UL function, 56% had very minimal infarction (<25%) of the ahPCG. Degree of paresis was statistically associated with presence or absence of detectable posterior PVWM damage but not with extent of ahPCG involvement. These preliminary findings suggest that posterior PVWM involvement may be a major, if not the principal, determinant of paresis in all hemispheric ischemic strokes and motivate further prospective studies of this problem.

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“…[20][21][22] The foot part of the homunculus is located at the most medial part of the precentral gyrus, and the hand part is lateral to the foot, whereas the tongue and face part are located at the most lateral aspect. Recently, several studies 9,[23][24][25] reported the location of the CST as an anterolateral-to-posteromedial alignment in the corona radiata and a medial-to-lateral alignment at the midbrain level. Other investigators 8,22 proposed that the foot fibers form an axis of rotation, around which the CST rotates anteriorly approximate 90°as they descended from the precentral gyrus to the internal capsule.…”

Section: Discussionmentioning

confidence: 99%

Somatotopic Organization of Motor Pathways in the Internal Capsule: A Probabilistic Diffusion Tractography Study

Pan

Peck

Young³

et al. 2012

AJNR Am J Neuroradiol

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Somatotopic Organization of Motor Fibers in the Corona Radiata in Monoparetic Patients With Small Subcortical Infarct

Cited by 38 publications

References 7 publications

A New Image-Based Stroke Registry Containing Quantitative Magnetic Resonance Imaging Data

A New Image-Based Stroke Registry Containing Quantitative Magnetic Resonance Imaging Data

Mechanisms of arm paresis in middle cerebral artery distribution stroke: Pilot study

Somatotopic Organization of Motor Pathways in the Internal Capsule: A Probabilistic Diffusion Tractography Study

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