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The Role of Corticospinal Tract Damage in Chronic Motor Recovery and Neurorehabilitation: A Pilot Study

Sterr, Annette, Shen, Shan, Szameitat, Andre J and Herron, Katherine A (2010) The Role of Corticospinal Tract Damage in Chronic Motor Recovery and Neurorehabilitation: A Pilot Study Neurorehabilitation and Neural Repair, 24 (5). pp. 413-419.

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Background. With diffusion-tensor imaging (DTi) it is possible to estimate the structural characteristics of fiber bundles in vivo. This study used DTi to infer damage to the corticospinal tract (CST) and relates this parameter to (a) the level of residual motor ability at least 1 year poststroke and (b) the outcome of intensive motor rehabilitation with constraintinduced movement therapy (CIMT). Objective. To explore the role of CST damage in recovery and CIMT efficacy. Methods. Ten patients with low-functioning hemiparesis were scanned and tested at baseline, before and after CIMT. Lesion overlap with the CST was indexed as reduced anisotropy compared with a CST variability map derived from 26 controls. Residual motor ability was measured through the Wolf Motor Function Test (WMFT) and the Motor Activity Log (MAL) acquired at baseline. CIMT benefit was assessed through the pre–post treatment comparison of WMFT and MAL performance. Results. Lesion overlap with the CST correlated with residual motor ability at baseline, with greater deficits observed in patients with more extended CST damage. Infarct volume showed no systematic association with residual motor ability. CIMT led to significant improvements in motor function but outcome was not associated with the extent of CST damage or infarct volume. Conclusion. The study gives in vivo support for the proposition that structural CST damage, not infarct volume, is a major predictor for residual functional ability in the chronic state. The results provide initial evidence for positive effects of CIMT in patients with varying, including more severe, CST damage. Keywords constraint-induced movement therapy, diffusion tensor imaging, chronic hemiplegia, upper limb, stroke rehabilitation, fractional anisotropy

Item Type: Article
Divisions : Faculty of Health and Medical Sciences > School of Psychology
Authors :
Shen, Shan
Szameitat, Andre J
Herron, Katherine A
Date : 2010
DOI : 10.1177/1545968309348310
Copyright Disclaimer : © The Author(s) 2010
Related URLs :
Depositing User : Annette Sterr
Date Deposited : 22 Aug 2017 08:04
Last Modified : 16 Jan 2019 16:32

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