Relationship Between Motor Function, DTI, and Neurophysiological Parameters in Patients with Stroke in the Recovery Rehabilitation unit

So what are you doing to change these failure to recover predictions? What protocols will change this to recovery?

Relationship Between Motor Function, DTI, and Neurophysiological Parameters in Patients with Stroke in the Recovery Rehabilitation unit 

Author links open overlay panelYoshitakaOkamotoPT, PhD^⁎DaisukeIshiiOT, PhD^†‡

SatoshiYamamotoPT, PhD^§KiyoshigeIshibashiPT, MS^¶MasahiroWakatabiPT, MS^¶YutakaKohnoMD, PhD^†KenjiNumataPT, PhD^#

https://doi.org/10.1016/j.jstrokecerebrovasdis.2021.105889Get rights and content

Abstract

Objectives

We investigated the relationship between pyramidal tract evaluation indexes (i.e., diffusion tensor imaging, transcranial magnetic stimulation (TMS)-induced motor-evoked potential (MEP), and central motor conduction time (CMCT) on admission to the recovery rehabilitation unit) and motor functions at discharge in patients with ischemic or hemorrhagic stroke.

Materials and Methods

Seventeen patients were recruited (12 men; 57.9 ± 10.3 years). The mean fractional anisotropy (FA) values of the right and left posterior limbs of the internal capsule were estimated using a computer-automated method. We determined the ratios of FA values in the affected and unaffected hemispheres (rFA), TMS-induced MEP, and the ratios of CMCT in the affected and unaffected hemispheres (rCMCT) and examined their association with motor functions (Fugl–Meyer Assessment (FMA) and Action Research Arm Test (ARAT)) at discharge.

Results

Higher rFA values of the posterior limb of the internal capsule on admission to the recovery rehabilitation unit led to a better recovery of upper limb function (FMA: r = 0.78, p < 0.001; ARAT: r = 0.74, p = 0.001). Patients without MEP had poorer recovery of upper limb function than those with MEP (FMA: p < 0.001; ARAT: p = 0.001). The higher the rCMCT, the poorer the recovery of upper limb function (ARAT: r = −0.93, p < 0.001). However, no association was observed between the pyramidal tract evaluation indexes and recovery of lower limb motor function.

Conclusions

Evaluating the pyramidal tract is useful for predicting upper limb function prognosis, but not for lower limb function prognosis.