Longitudinal study of diffusion tensor imaging properties of affected cortical spinal tracts in acute and chronic hemorrhagic stroke

J Clin Neurosci. 2014 Aug;21(8):1388-92. doi: 10.1016/j.jocn.2013.11.032. Epub 2014 Apr 16.

Abstract

This study investigated the clinical value of diffusion tensor imaging (DTI) in predicting the motor outcome in patients with basal ganglia hemorrhage. This prospective study included 23 patients assessed with DTI to measure the fractional anisotropy (FA) value in affected cortical spinal tract (CST) at three time points: day 0, day 30 and day 90 after onset. The motor function score (MFS) was applied to evaluate motor function and patients were divided into good and poor outcome groups according to the MFS on day 90. The mean FA value on day 0 was significantly lower in the poor outcome group than in the good outcome group (p<0.01). FA value gradually decreased in the poor outcome group until day 90 after onset, while it continuously increased in the good outcome group. The MFS obtained at day 90 after onset was significantly correlated with the initial FA value in the affected cerebral peduncle (r=-0.926, p<0.01). Receiver operating characteristic curve analysis showed that the FA value on day 0 could predict motor function outcome with a sensitivity of 88.89% and specificity of 92.86% at the initial FA value of 0.45. The FA value of affected CST in acute cerebral hemorrhage may valuably predict the motor function outcome and its dynamic change may represent the Wallerian degeneration in motor tracts after hemorrhagic stroke.

Keywords: Basal ganglia hemorrhage; Cortical spinal tract; Diffusion tensor imaging; Fractional anisotropy; Motor function score.

MeSH terms

  • Acute Disease
  • Adult
  • Aged
  • Anisotropy
  • Cerebral Peduncle / pathology
  • Chronic Disease
  • Diffusion Tensor Imaging
  • Disability Evaluation
  • Female
  • Humans
  • Intracranial Hemorrhages / pathology*
  • Intracranial Hemorrhages / physiopathology
  • Longitudinal Studies
  • Male
  • Middle Aged
  • Motor Activity
  • Prognosis
  • Prospective Studies
  • Pyramidal Tracts / pathology*
  • Recovery of Function
  • Sensitivity and Specificity
  • Stroke / pathology*
  • Stroke / physiopathology
  • Treatment Outcome