Predicting functional motor potential in chronic stroke patients using diffusion tensor imaging

Not even close to being useful. Recovery predictions right now are just predictions of 100% recovery failure and this is even worse. Predicting 'potential' motor something or other rather than actual motor recovery. 

And yet the mentors and senior researchers were OK with this crapola.

Predicting functional motor potential in chronic stroke patients using diffusion tensor imaging

 Robert Lindenberg, 1 *
 Lin L. Zhu, 1
Theodor Ru¨ber,1,2
and Gottfried Schlaug1 *
1 Department of Neurology, Neuroimaging and Stroke Recovery Laboratories, Beth Israel Deaconess Medical Center/Harvard Medical School, Boston, Massachusetts
2 Department of Epileptology, Bonn University Hospital, Bonn, Germany

Abstract:

 Electrophysiological and neuroimaging studies suggest that the integrity of ipsilesional and inter-hemispheric motor circuits is important for motor recovery after stroke. However, the extent to which each of these tracts contributes to the variance in outcome remains unclear. We examined whether diffusion tensor imaging (DTI)-derived measures of corticospinal and transcallosal tracts predict motor improvement in an experimental neurorehabilitation trial. 15 chronic stroke patientsreceived bihemispheric transcranial direct current stimulation and simultaneous physical/occupational therapy for five consecutive days. Motor impairment was assessed prior to and after the intervention.At baseline, the patients underwent DTI; probabilistic fiber tracking was used to reconstruct the pyramidal tract (PT), alternate descending motor fibers (aMF), and transcallosal fibers connecting primary motor cortices (M1-M1). Ipsilesional corticospinal tracts (PT, aMF) and M1-M1 showed significantly decreased fractional anisotropy (FA) and increased directional diffusivities when compared to age-matched healthy controls. Partial correlations revealed that greater gains in motor function were related to higher FA values and lower directional diffusivities of transcallosal and ipsilesional corticospinal tracts. M1-M1 diffusivity had the greatest predictive value. An additional slice-by-slice analysisof FA values along the corticospinal tracts demonstrated that the more the ipsilesional FA profiles of patients resembled those of healthy controls, the greater their functional improvement. In conclusion,our study shows that DTI-derived measures can be used to predict functional potential for subsequent motor recovery in chronic stroke patients. Diffusivity parameters of individual tracts and tract combinations may help in assessing a patient’s individual recovery potential and in determining optimal neurorehabilitative interventions.
 Hum Brain Mapp 00:000–000, 2011

Keywords:
 alternate motor fibers; corticospinal tract; directional diffusivity; fractional anisotropy;inter-hemispheric interaction; motor impairment; pyramidal tract; transcallosal fibers