TY - JOUR
T1 - White matter integrity and chronic poststroke upper limb function
T2 - An ENIGMA stroke recovery analysis
AU - Domin, Martin
AU - Hordacre, Brenton
AU - Hok, Pavel
AU - Boyd, Lara A.
AU - Conforto, Adriana B.
AU - Andrushko, Justin W.
AU - Borich, Michael R.
AU - Craddock, Richard C.
AU - Donnelly, Miranda R.
AU - Dula, Adrienne N.
AU - Warach, Steven J.
AU - Kautz, Steven A.
AU - Lo, Bethany P.
AU - Schranz, Christian
AU - Seo, Na Jin
AU - Srivastava, Shraddha
AU - Wong, Kristin A.
AU - Zavaliangos-Petropulu, Artemis
AU - Thompson, Paul M.
AU - Liew, Sook Lei
AU - Lotze, Martin
N1 - Funding Information: Dr Hordacre has a clinical partnership with Fourier Intelligence. Dr Conforto is a consultant for Boehringer Ingelheim. Dr Kautz reports grants from US Department of Veterans Affairs and grants from National Institute of General Medical Sciences. Dr Thompson has received research grant support from Biogen, Inc, for research unrelated to this article. Dr Warach is a consultant for Genentech and BrainsGate. The other authors report no conflicts.
PY - 2023/9/1
Y1 - 2023/9/1
N2 - BACKGROUND: Integrity of the corticospinal tract (CST) is an important biomarker for upper limb motor function following stroke. However, when structurally compromised, other tracts may become relevant for compensation or recovery of function. METHODS: We used the ENIGMA Stroke Recovery data set, a multicenter, retrospective, and cross-sectional collection of patients with upper limb impairment during the chronic phase of stroke to test the relevance of tracts in individuals with less and more severe (laterality index of CST fractional anisotropy ≥0.25) CST damage in an observational study design. White matter integrity was quantified using fractional anisotropy for the CST, the superior longitudinal fascicle, and the callosal fibers interconnecting the primary motor cortices between hemispheres. Optic radiations served as a control tract as they have no a priori relevance for the motor system. Pearson correlation was used for testing correlation with upper limb motor function (Fugl-Meyer upper extremity). xRESULTS: From 1235 available data sets, 166 were selected (by imaging, Fugl-Meyer upper extremity, covariates, stroke location, and stage) for analyses. Only individuals with severe CST damage showed a positive association of fractional anisotropy in both callosal fibers interconnecting the primary motor cortices (r[21]=0.49; P=0.025) and superior longitudinal fascicle (r[21]=0.51; P=0.018) with Fugl-Meyer upper extremity. CONCLUSIONS: Our data support the notion that individuals with more severe damage of the CST depend on residual pathways for achieving better upper limb outcome than those with less affected CST.
AB - BACKGROUND: Integrity of the corticospinal tract (CST) is an important biomarker for upper limb motor function following stroke. However, when structurally compromised, other tracts may become relevant for compensation or recovery of function. METHODS: We used the ENIGMA Stroke Recovery data set, a multicenter, retrospective, and cross-sectional collection of patients with upper limb impairment during the chronic phase of stroke to test the relevance of tracts in individuals with less and more severe (laterality index of CST fractional anisotropy ≥0.25) CST damage in an observational study design. White matter integrity was quantified using fractional anisotropy for the CST, the superior longitudinal fascicle, and the callosal fibers interconnecting the primary motor cortices between hemispheres. Optic radiations served as a control tract as they have no a priori relevance for the motor system. Pearson correlation was used for testing correlation with upper limb motor function (Fugl-Meyer upper extremity). xRESULTS: From 1235 available data sets, 166 were selected (by imaging, Fugl-Meyer upper extremity, covariates, stroke location, and stage) for analyses. Only individuals with severe CST damage showed a positive association of fractional anisotropy in both callosal fibers interconnecting the primary motor cortices (r[21]=0.49; P=0.025) and superior longitudinal fascicle (r[21]=0.51; P=0.018) with Fugl-Meyer upper extremity. CONCLUSIONS: Our data support the notion that individuals with more severe damage of the CST depend on residual pathways for achieving better upper limb outcome than those with less affected CST.
KW - corticospinal tract
KW - diffusion tensor imaging
KW - neuroimaging
KW - stroke
KW - upper extremity
KW - white matter
UR - http://www.scopus.com/inward/record.url?scp=85169177417&partnerID=8YFLogxK
U2 - 10.1161/STROKEAHA.123.043713
DO - 10.1161/STROKEAHA.123.043713
M3 - Article
C2 - 37465999
AN - SCOPUS:85169177417
SN - 0039-2499
VL - 54
SP - 2438
EP - 2441
JO - Stroke
JF - Stroke
IS - 9
ER -
