Tags

Type your tag names separated by a space and hit enter

Mesencephalic corticospinal atrophy predicts baseline deficit but not response to unilateral or bilateral arm training in chronic stroke.
Neurorehabil Neural Repair 2011; 25(1):81-7NN

Abstract

OBJECTIVE

Stroke survivors with motor deficits often have pyramidal tract atrophy caused by degeneration of corticospinal fibers. The authors hypothesized that the degree of atrophy correlates with severity of motor impairment in patients with chronic stroke and predicts the response to rehabilitation training.

METHODS

They performed a post hoc analysis of 42 hemiparetic patients (>6 months) who had been randomized to either 6 weeks of bilateral arm training with rhythmic auditory cueing (BATRAC) or dose-matched therapeutic exercise (DMTE). Arm function was measured using the Fugl-Meyer (FM) and modified Wolf Motor Function Test (WMFT). Structural MRI and diffusion tensor imaging (DTI) on the pontine level measured corticospinal tract (CST) atrophy by planimetric measurement of the mesencephalon (mesencephalic atrophy ratio) and fractional anisotropy (FA), respectively. Voxel-based lesion symptom mapping (VLSM) was used to determine the lesions associated with highest degrees of atrophy. The predictive value of CST atrophy for impairment and training response was analyzed.

RESULTS

CST atrophy predicted baseline motor arm function measured by the FM and WMFT. The authors found only a trend for the correlation with FA. No measure of atrophy predicted response to either BATRAC or DMTE. CST atrophy was higher with larger lesions and those that affected the CST. VLSM identified internal capsule lesions as being associated with highest CST atrophy.

CONCLUSION

Larger lesions, internal capsule lesions, and those overlapping the pyramidal tract are associated with greater CST atrophy. CST atrophy explains in part the variability of baseline deficits but does not seem to predict the response to BATRAC or unilateral arm training on upper-extremity function.

Authors+Show Affiliations

Department of Neurology, University of Zürich, Zürich, Switzerland. cglobas@web.deNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Clinical Trial
Journal Article
Randomized Controlled Trial
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

20947492

Citation

Globas, Christoph, et al. "Mesencephalic Corticospinal Atrophy Predicts Baseline Deficit but Not Response to Unilateral or Bilateral Arm Training in Chronic Stroke." Neurorehabilitation and Neural Repair, vol. 25, no. 1, 2011, pp. 81-7.
Globas C, Lam JM, Zhang W, et al. Mesencephalic corticospinal atrophy predicts baseline deficit but not response to unilateral or bilateral arm training in chronic stroke. Neurorehabil Neural Repair. 2011;25(1):81-7.
Globas, C., Lam, J. M., Zhang, W., Imanbayev, A., Hertler, B., Becker, C., ... Luft, A. R. (2011). Mesencephalic corticospinal atrophy predicts baseline deficit but not response to unilateral or bilateral arm training in chronic stroke. Neurorehabilitation and Neural Repair, 25(1), pp. 81-7. doi:10.1177/1545968310382001.
Globas C, et al. Mesencephalic Corticospinal Atrophy Predicts Baseline Deficit but Not Response to Unilateral or Bilateral Arm Training in Chronic Stroke. Neurorehabil Neural Repair. 2011;25(1):81-7. PubMed PMID: 20947492.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Mesencephalic corticospinal atrophy predicts baseline deficit but not response to unilateral or bilateral arm training in chronic stroke. AU - Globas,Christoph, AU - Lam,Judith M, AU - Zhang,Weihong, AU - Imanbayev,Anuar, AU - Hertler,Benjamin, AU - Becker,Clemens, AU - Whitall,Jill, AU - McCombe-Waller,Sandy, AU - Mori,Susumu, AU - Hanley,Daniel F, AU - Luft,Andreas R, Y1 - 2010/10/13/ PY - 2010/10/16/entrez PY - 2010/10/16/pubmed PY - 2011/4/27/medline SP - 81 EP - 7 JF - Neurorehabilitation and neural repair JO - Neurorehabil Neural Repair VL - 25 IS - 1 N2 - OBJECTIVE: Stroke survivors with motor deficits often have pyramidal tract atrophy caused by degeneration of corticospinal fibers. The authors hypothesized that the degree of atrophy correlates with severity of motor impairment in patients with chronic stroke and predicts the response to rehabilitation training. METHODS: They performed a post hoc analysis of 42 hemiparetic patients (>6 months) who had been randomized to either 6 weeks of bilateral arm training with rhythmic auditory cueing (BATRAC) or dose-matched therapeutic exercise (DMTE). Arm function was measured using the Fugl-Meyer (FM) and modified Wolf Motor Function Test (WMFT). Structural MRI and diffusion tensor imaging (DTI) on the pontine level measured corticospinal tract (CST) atrophy by planimetric measurement of the mesencephalon (mesencephalic atrophy ratio) and fractional anisotropy (FA), respectively. Voxel-based lesion symptom mapping (VLSM) was used to determine the lesions associated with highest degrees of atrophy. The predictive value of CST atrophy for impairment and training response was analyzed. RESULTS: CST atrophy predicted baseline motor arm function measured by the FM and WMFT. The authors found only a trend for the correlation with FA. No measure of atrophy predicted response to either BATRAC or DMTE. CST atrophy was higher with larger lesions and those that affected the CST. VLSM identified internal capsule lesions as being associated with highest CST atrophy. CONCLUSION: Larger lesions, internal capsule lesions, and those overlapping the pyramidal tract are associated with greater CST atrophy. CST atrophy explains in part the variability of baseline deficits but does not seem to predict the response to BATRAC or unilateral arm training on upper-extremity function. SN - 1552-6844 UR - https://www.unboundmedicine.com/medline/citation/20947492/Mesencephalic_corticospinal_atrophy_predicts_baseline_deficit_but_not_response_to_unilateral_or_bilateral_arm_training_in_chronic_stroke_ L2 - http://journals.sagepub.com/doi/full/10.1177/1545968310382001?url_ver=Z39.88-2003&rfr_id=ori:rid:crossref.org&rfr_dat=cr_pub=pubmed DB - PRIME DP - Unbound Medicine ER -