How will your doctor guarantee the structural integrity of the ipsilesional corticospinal tract(CST) and the transcallosal motor tract? You will need protocols that fix this if the integrity is compromised. YOUR DOCTOR'S RESPONSIBILITY!
Changes in Structural Integrity Are Correlated With Motor and Functional Recovery After Post-stroke Rehabilitation
Restorative Neurology and Neuroscience 33 (2015) 835–844DOI 10.3233/RNN-150523IOS Press
Yang-teng Fan a,1,
Yang-teng Fan a,1,
Keh-chung Lin a,b,1,
Ho-ling Liu c,
Yao-liang Chen d and
Ching-yi Wu e,f,∗
a School of Occupational Therapy, College of Medicine, National Taiwan University, Taipei, Taiwan
b Division of Occupational Therapy, Department of Physical Medicine and Rehabilitation, National Taiwan University Hospital, Taipei, Taiwan
c Department of Imaging Physics, Division of Diagnostic Imaging, The University of Texas MD AndersonCancer Center, Houston, TX, USA
d MRI Center, Chang Gung Memorial Hospital, Taoyuan, Taiwan
e Department of Occupational Therapy and Graduate Institute of Behavioral Sciences, College of Medicine,Chang Gung University, Taoyuan, Taiwan
f Healthy Aging Research Center, Chang Gung University, Taoyuan, Taiwan
Purpose:
Diffusion tensor imaging(DTI) studies indicate the structural integrity of the ipsilesional corticospinal tract(CST) and the transcallosal motor tract, which are closely linked to stroke recovery. However, the individual contribution of these 2 fiberson different levels of outcomes remains unclear. Here, we used DTI tractography to investigate whether structural changes of the ipsilesional CST and the transcallosal motor tracts associate with motor and functional recovery after stroke rehabilitation.
Methods:
Ten participants with post-acute stroke underwent the Fugl-Meyer Assessment (FMA), the Wolf Motor Function Test(WMFT), the Functional Independence Measure (FIM), and DTI before and after bilateral robotic training.
Results:
All participants had marked improvements in motor performance, functional use of the affected arm, and independence in daily activities. Increased fractional anisotropy (FA) in the ipsilesional CST and the transcallosal motor tracts was noted from pre-treatment to the end of treatment. Participants with higher pre-to-post differences in FA values of the transcallosal motortracts had greater gains in the WMFT and the FIM scores. A greater improvement on the FMA was coupled with increased FA changes along the ipsilesional CST.
Conclusions:
These findings suggest 2 different structural indicators for post stroke recovery separately at the impairment based and function based levels.
a School of Occupational Therapy, College of Medicine, National Taiwan University, Taipei, Taiwan
b Division of Occupational Therapy, Department of Physical Medicine and Rehabilitation, National Taiwan University Hospital, Taipei, Taiwan
c Department of Imaging Physics, Division of Diagnostic Imaging, The University of Texas MD AndersonCancer Center, Houston, TX, USA
d MRI Center, Chang Gung Memorial Hospital, Taoyuan, Taiwan
e Department of Occupational Therapy and Graduate Institute of Behavioral Sciences, College of Medicine,Chang Gung University, Taoyuan, Taiwan
f Healthy Aging Research Center, Chang Gung University, Taoyuan, Taiwan
Abstract
.Purpose:
Diffusion tensor imaging(DTI) studies indicate the structural integrity of the ipsilesional corticospinal tract(CST) and the transcallosal motor tract, which are closely linked to stroke recovery. However, the individual contribution of these 2 fiberson different levels of outcomes remains unclear. Here, we used DTI tractography to investigate whether structural changes of the ipsilesional CST and the transcallosal motor tracts associate with motor and functional recovery after stroke rehabilitation.
Methods:
Ten participants with post-acute stroke underwent the Fugl-Meyer Assessment (FMA), the Wolf Motor Function Test(WMFT), the Functional Independence Measure (FIM), and DTI before and after bilateral robotic training.
Results:
All participants had marked improvements in motor performance, functional use of the affected arm, and independence in daily activities. Increased fractional anisotropy (FA) in the ipsilesional CST and the transcallosal motor tracts was noted from pre-treatment to the end of treatment. Participants with higher pre-to-post differences in FA values of the transcallosal motortracts had greater gains in the WMFT and the FIM scores. A greater improvement on the FMA was coupled with increased FA changes along the ipsilesional CST.
Conclusions:
These findings suggest 2 different structural indicators for post stroke recovery separately at the impairment based and function based levels.
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