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INTERACTIONS BETWEEN THE CORTICOSPINAL AND CORTICOCEREBELLAR TRACTS FOR UPPER EXTREMITY MOTOR RECOVERY AFTER STROKE
Background and Aims
The cortico-spinal tract (CST) and cortico-cerebellar tract (CCT) are known as biomarkers for upper extremity (UE) recovery after stroke. Understanding this relationship may help to predict UE recovery and give useful information for treatment strategies of stroke patients.
Forty-two first-ever ischemic stroke patients, who had diffusion tensor imaging at two weeks and motor function assessment using Fugl-Meyer Assessment scale at two weeks and three months after onset, were included. Individual data were preprocessed, and functional anisotropy (FA) maps were generated using the FSL. To obtain region-specific FA values, the posterior limb of the internal capsule (PLIC), cerebral peduncle (CP), and superior cerebellar peduncle (SCP) were extracted from the JHU ICBM-DTI-81 atlas. The FA value in combined PLIC and CP regions and the FA value in the SCP region were used as the CST and CCT integrity, respectively. The linear regression was used to identify the relationship and predictive accuracy.
The CST integrity had predictive values (p=0.0015) of UE recovery, but the CCT integrity was not (p=0.3350). In the multivariate model, there were interaction effects between the CST and CCT integrity (p=0.0241). Predictive accuracy using an interaction term of the CST and CCT integrity was higher than using the CST integrity only (CST*CCT; R2=0.360, CST; R2=0.224).
In UE recovery of stroke patients, the significance of the CCT depended on the CST integrity. Considering both CST and CCT may improve prediction accuracy of UE recovery of stroke patients. This study was supported by NRF grants (NRF-2020R1A2C3010304, NRF-2020R1C1C1011688), Republic of Korea.