Abstract
Background.
Corticospinal tract (CST) damage is considered a biomarker for stroke
recovery. Several methods have been used to define CST damage and
examine its relationship to motor performance, but which method is most
useful remains unclear. Proprioceptive impairment also affects stroke
recovery and may be related to CST damage.
Methods. Robotic
assessment quantified upper-limb motor and proprioceptive performance at
2 weeks and 6 months poststroke (n = 149). Three previously-established
CST lesion metrics were calculated using clinical neuroimaging.
Diffusion magnetic resonance imaging quantified CST microstructure in a
subset of participants (n = 21). Statistical region of interest (sROI)
analysis identified lesion locations associated with motor and
proprioceptive deficits.
Results. CST lesion metrics were
moderately correlated with motor scores at 2 weeks and 6 months
poststroke. CST fractional anisotropy (FA) was correlated with motor
scores at 1 month poststroke, but not at 6 months. The FA ratio of the
posterior limb of the internal capsule was not correlated with motor
performance. CST lesion metrics were moderately correlated with
proprioceptive scores at 2 weeks and 6 months poststroke. sROI analysis
confirmed that CST damage was associated with motor and proprioceptive
deficits and additionally found that putamen, internal capsule, and
corticopontocerebellar tract lesions were associated with poor motor
performance.
Conclusions. Across all methods used to quantify CST
damage, correlations with motor or proprioceptive performance were
moderate at best. Future research is needed to identify complementary or
alternative biomarkers to address the complexity and heterogeneity of
stroke recovery.
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