Corticospinal Tract Change during Motor Recovery in Patients with Medulla Infarct: A Diffusion Tensor Imaging Study

Diffusion tensor imaging (DTI) and tractography (DTT) provide a powerful vehicle for investigating motor recovery mechanisms. However, little is known about these mechanisms in patients with medullary lesions. We used DTI and DTT to evaluate three patients presenting with motor deficits following unilateral medulla infarct. Patients were scanned three times during 1 month (within 7, 14, and 30 days after stroke onset). Fractional anisotropy (FA) values were measured in the medulla, cerebral peduncle, and internal capsule. The three-dimensional corticospinal tract (CST) was reconstructed using DTT. Patients 1 and 2 showed good motor recovery after 14 days, and the FA values of their affected CST were slightly decreased. DTTs demonstrated that the affected CST passed along periinfarct areas and that tract integrity was preserved in the medulla. Patient 3 had the most obvious decrease in FA values along the affected CST, with motor deficits of the right upper extremity after 30 days. The affected CST passed through the infarct and was disrupted in the medulla. In conclusion, DTI can detect the involvement and changes of the CST in patients with medulla infarct during motor recovery. The degree of degeneration and spared periinfarct CST compensation may be an important motor recovery mechanism.

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Migraine affects white-matter tract integrity: A diffusion-tensor imaging study

Cephalalgia ◽

10.1177/0333102415573513 ◽

2015 ◽

Vol 35 (13) ◽

pp. 1162-1171 ◽

Cited By ~ 26

Author(s):

Catherine D Chong ◽

Todd J Schwedt

Keyword(s):

Diffusion Tensor Imaging ◽

White Matter ◽

Corticospinal Tract ◽

Diffusion Tensor ◽

Mean Diffusivity ◽

Imaging Study ◽

White Matter Tract ◽

Inferior Longitudinal Fasciculus ◽

Left And Right ◽

The Right

Background Specific white-matter tract alterations in migraine remain to be elucidated. Using diffusion tensor imaging (DTI), this study investigated whether the integrity of white-matter tracts that underlie regions of the “pain matrix” is altered in migraine and interrogated whether the number of years lived with migraine modifies fibertract structure. Methods Global probabilistic tractography was used to assess the anterior thalamic radiations, the corticospinal tracts and the inferior longitudinal fasciculi in 23 adults with migraine and 18 healthy controls. Results Migraine patients show greater mean diffusivity (MD) in the left and right anterior thalamic radiations, the left corticospinal tract, and the right inferior longitudinal fasciculus tract. Migraine patients also show greater radial diffusivity (RD) in the left anterior thalamic radiations, the left corticospinal tract as well as the left and right inferior longitudinal fasciculus tracts. No group fractional anisotropy (FA) differences were identified for any tracts. Migraineurs showed a positive correlation between years lived with migraine and MD in the right anterior thalamic radiations ( r = 0.517; p = 0.012) and the left corticospinal tract ( r = 0.468; p = 0.024). Conclusion Results indicate that white-matter integrity is altered in migraine and that longer migraine history is positively correlated with greater alterations in tract integrity.

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Delineation of the Safe Zone in Surgery of Sylvian Insular Triangle: Morphometric Analysis and Magnetic Resonance Imaging Study

Operative Neurosurgery ◽

10.1227/neu.0b013e3182315112 ◽

2011 ◽

Vol 70 (suppl_2) ◽

pp. ons290-ons299 ◽

Cited By ~ 1

Author(s):

Nobuyuki Kaneko ◽

Warren W. Boling ◽

Takaharu Shonai ◽

Kazumi Ohmori ◽

Yoshiaki Shiokawa ◽

...

Keyword(s):

Diffusion Tensor Imaging ◽

Corticospinal Tract ◽

Diffusion Tensor ◽

Significant Risk ◽

Imaging Study ◽

Internal Capsule ◽

Posterior Limb ◽

3.0 T ◽

Relationship Of ◽

The Relationship

ABSTRACT BACKGROUND: Surgery within the insula carries significant risk of morbidity, particularly hemiparesis, because of the difficulty in detecting the internal capsule boundaries. OBJECTIVE: We analyzed the anatomy of the insula and identified landmarks anticipated to facilitate surgery for intrinsic insular lesions. METHODS: Insular region anatomy was studied in 11 cadaveric brains harvested within 72 hours postmortem. MRI of the specimens was acquired using 3.0 T with T2-weighting and 25 directions of diffusion tensor imaging. Landmarks easily recognizable during surgery were identified on the surface of the insula. The interrelationships between surface landmarks and critical structures were analyzed. RESULTS: The posterior inferior insular point (PIIP) and the upper central insular point (UCIP) were newly established as landmarks on the insula. The PIIP corresponded to the obvious bend in the posterior long insular gyrus. The UCIP is the meeting point between the central insular sulcus and superior peri-insular sulcus. The corticospinal tract was identified as a high-intensity area in the posterior limb of the internal capsule on T2-weighted imaging and its course confirmed with diffusion tensor imaging tractography. The corticospinal tract took a course deep to the posterosuperior insula on T2-weighted imaging, 4.8 mm from the UCIP and 6.2 mm from the PIIP. CONCLUSION: The posterosuperior part of the insula forms the region at greatest risk to corticospinal tract injury. The PIIP and UCIP are crucial to understanding the relationship of the insula with the posterior limb of the internal capsule including the corticospinal tract.

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Chronic pontine strokes: Diffusion tensor imaging of corticospinal tract indicates the prognosis in terms of motor outcome

Journal of X-Ray Science and Technology ◽

10.3233/xst-200817 ◽

2021 ◽

pp. 1-13

Author(s):

Qian Xue ◽

Xiao-Han Yang ◽

Gao-Jun Teng ◽

Shu-Dong Hu

Keyword(s):

Diffusion Tensor Imaging ◽

Corticospinal Tract ◽

Diffusion Tensor ◽

Internal Capsule ◽

Outcome Evaluation ◽

Cerebral Peduncle ◽

Precentral Gyrus ◽

Posterior Limb ◽

Motor Outcome ◽

Motor Outcomes

OBJECTIVE: To investigate relationship between the diffusion indexes of corticospinal tract (CST) and the neurological motor outcomes in chronic pontine stroke patients. METHODS: Diffusion tensor imaging (DTI) is performed in 27 patients with chronic pontine stroke. Fractional anisotropy (FA) values along the CST area, the track number, and the CST length are measured. Neurological and motor outcomes are evaluated based on Fugl-meyer (FM), National Institutes of Health Stroke Scale (NIHSS), Barthel index (BI), and modified Rankin scale (mRS) scores. The relationships between FA ratios (rFAs) in the CST of stroke subjects and their clinical motor scores are analyzed through Spearman’s correlation analysis. Then, diffusion tensor tractography (DTT) is performed to show the injury degree of CST. RESULTS: First, FA values are decreased in the infarct area, cerebral peduncle, posterior limb of the internal capsule, and precentral gyrus compared with those in the contralateral side. The number of CST is decreased in the ipsilateral side of the infarct. Second, rFAs in the cerebral peduncle, posterior limb of the internal capsule, and CST rnum correlate positively with FM scores (r = 0.824, 0.672, 0.651, p < 0.001) and negatively with mRS scores (r = –0.835, –0.604, –0.645, p≤0.001). Third, the injury degree of CST correlates negatively with FM scores (r = –0.627, p < 0.001). CONCLUSIONS: The study demonstrates that rFAs in the cerebral peduncle, posterior limb of the internal capsule, and CST rnum associate with motor outcome, suggesting that DTI may be applicable for outcome evaluation.

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Prediction of motor outcome using remaining corticospinal tract in patients with pontine infarct: Diffusion tensor imaging study

Somatosensory & Motor Research ◽

10.1080/08990220.2016.1194821 ◽

2016 ◽

Vol 33 (2) ◽

pp. 99-103 ◽

Cited By ~ 2

Author(s):

Sung Ho Jang ◽

Jun Lee ◽

Mi Young Lee ◽

So Min Park ◽

Won Hee Choi ◽

...

Keyword(s):

Diffusion Tensor Imaging ◽

Corticospinal Tract ◽

Diffusion Tensor ◽

Imaging Study ◽

Motor Outcome ◽

Diffusion Tensor Imaging Study ◽

Pontine Infarct

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White matter plasticity in the corticospinal tract of musicians: A diffusion tensor imaging study

NeuroImage ◽

10.1016/j.neuroimage.2009.02.025 ◽

2009 ◽

Vol 46 (3) ◽

pp. 600-607 ◽

Cited By ~ 178

Author(s):

Adrian Imfeld ◽

Mathias S. Oechslin ◽

Martin Meyer ◽

Thomas Loenneker ◽

Lutz Jancke

Keyword(s):

Diffusion Tensor Imaging ◽

White Matter ◽

Corticospinal Tract ◽

Diffusion Tensor ◽

Imaging Study ◽

Diffusion Tensor Imaging Study

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Aging of corticospinal tract fibers according to the cerebral origin in the human brain: A diffusion tensor imaging study

Neuroscience Letters ◽

10.1016/j.neulet.2014.11.030 ◽

2015 ◽

Vol 585 ◽

pp. 77-81 ◽

Cited By ~ 14

Author(s):

Sung Ho Jang ◽

Jeong Pyo Seo

Keyword(s):

Diffusion Tensor Imaging ◽

Human Brain ◽

Corticospinal Tract ◽

Diffusion Tensor ◽

Imaging Study ◽

Diffusion Tensor Imaging Study

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Abstract WP366: Quantitative Diffusion Tensor Tractography of the Corticospinal Tract as a Predictive Outcome Parameter in Patients With Intracerebral Hemorrhage

Stroke ◽

10.1161/str.48.suppl_1.wp366 ◽

2017 ◽

Vol 48 (suppl_1) ◽

Author(s):

Bastian Volbers ◽

Angelika Mennecke ◽

Nicola Kästle ◽

Hagen B Huttner ◽

Stefan Schwab ◽

...

Keyword(s):

Intracerebral Hemorrhage ◽

Corticospinal Tract ◽

Diffusion Tensor ◽

Clinical Status ◽

Internal Capsule ◽

Favorable Outcome ◽

Outcome Variable ◽

Cerebral Peduncle ◽

Prognostic Impact ◽

Posterior Limb

Introduction: Intracerebral hemorrhage (ICH) is a devastating disease with poor outcome. Established predictive markers include initial hematoma size, clinical status, intraventricular bleeding and age. However, prognostic assessment is often difficult which additionally burdens patients and caregivers and complicates rehabilitation. Functional outcome especially relies on motor function which is correlated with the integrity of the Corticospinal Tract (CST). Diffusion Tensor (DT) Tractography allows visualization of the CST. However, sufficient data about the prognostic impact of quantitative CST assessment is lacking. Methods: We prospectively enrolled patients with spontaneous supratentorial ICH admitted between 08/2012 und 08/2015. Informed consent and ethical approval was obtained. MRI scan was performed on day 5±1. DT data was normalized to MNI Space and Q-Space diffeomorphic reconstruction was performed using DSI-studio. CST was reconstructed based on quantitative anisotropy (QA) using the CST region (JHU white matter atlas) as seeding region and cerebral peduncle as region of interest (ROI). Fractional Anisotropy (FA) and QA were analyzed in the seeding and ROI region and in the posterior limb of the internal capsule (PLIC). Dichotomized modified Rankin Scale on day 90 (favorable outcome = mRS 0-2) was assessed as primary outcome variable. Results: 33 patients, mean age 70.7 y (standard deviation (SD) 12.9), 12 male, 21 with lobar hemorrhage, mean ICH volume on admission 16.5 (SD 11.3) cm 3 were included. 16 patients had a favorable outcome on day 90 (median mRS 3 (IQR 1-3.5). Mean number of reconstructed CST fiber pathways ipsilateral to ICH was higher in patients with favorable outcome (11343 (SD 8201)) than in patients with unfavorable outcome (4868 (SD 3221), p=0.008). Median QA and FA values in the PLIC ipsilateral to ICH were also higher in patients with favorable outcome (QA: 18.9 (IQR 16.2-23.3) vs. 14.6 (IQR 11.7 - 17.7), p=0.016, FA: 0.49 (IQR 0.45-0.53) vs. 0.41 (IQR 0.38-0.49), p=0.026). Conclusion: Higher FA- and QA-values in the PLIC and higher numbers of CST fiber pathways ipsilateral to ICH seem to be associated with a favorable outcome. DT Imaging may turn out as a useful quantitative predictive marker in the acute phase of ICH.

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Corticospinal tract involvement in spinocerebellar ataxia type 3: a diffusion tensor imaging study

Neuroradiology ◽

10.1007/s00234-020-02528-3 ◽

2020 ◽

Author(s):

Bruno Shigueo Yonekura Inada ◽

Thiago Junqueira Ribeiro Rezende ◽

Fernando Vieira Pereira ◽

Lucas Ávila Lessa Garcia ◽

Antônio José da Rocha ◽

...

Keyword(s):

Diffusion Tensor Imaging ◽

Spinocerebellar Ataxia ◽

Corticospinal Tract ◽

Diffusion Tensor ◽

Imaging Study ◽

Spinocerebellar Ataxia Type ◽

Spinocerebellar Ataxia Type 3 ◽

Tract Involvement ◽

Type 3 ◽

Diffusion Tensor Imaging Study

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Diffusion Tensor Imaging Evaluation of Corticospinal Tract Hyperintensity in Upper Motor Neuron-Predominant ALS Patients

Journal of Aging Research ◽

10.4061/2011/481745 ◽

2011 ◽

Vol 2011 ◽

pp. 1-9 ◽

Cited By ~ 8

Author(s):

Venkateswaran Rajagopalan ◽

Didier Allexandre ◽

Guang H. Yue ◽

Erik P. Pioro

Keyword(s):

Diffusion Tensor Imaging ◽

Motor Neuron ◽

Corticospinal Tract ◽

Diffusion Tensor ◽

Mean Diffusivity ◽

Internal Capsule ◽

Proton Density ◽

Imaging Evaluation ◽

Axonal Pathology ◽

Als Patients

Amyotrophic lateral sclerosis (ALS) patients with predominant upper motor neuron (UMN) signs occasionally have hyperintensity of corticospinal tract (CST) on T2- and proton-density-(PD-) weighted brain images. Diffusion tensor imaging (DTI) was used to assess whether diffusion parameters along intracranial CST differ in presence or absence of hyperintensity and correspond to UMN dysfunction. DTI brain scans were acquired in 47 UMN-predominant ALS patients with (n=21) or without (n=26) CST hyperintensity and in 10 control subjects. Fractional anisotropy (FA), mean diffusivity (MD), axial diffusivity (AD), and radial diffusivity (RD) were measured in four regions of interests (ROIs) along CST. Abnormalities (P<0.05) were observed in FA, AD, or RD in CST primarily at internal capsule (IC) level in ALS patients, especially those with CST hyperintensity. Clinical measures corresponded well with DTI changes at IC level. The IC abnormalities suggest a prominent axonopathy in UMN-predominant ALS and that tissue changes underlying CST hyperintensity have specific DTI changes, suggestive of unique axonal pathology.

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