Effects of Diabetes on Motor Recovery After Cerebral Infarct: A Diffusion Tensor Imaging Study

2019 ◽  
Vol 104 (9) ◽  
pp. 3851-3858 ◽  
Author(s):  
Jun Sung Moon ◽  
Seung Min Chung ◽  
Sung Ho Jang ◽  
Kyu Chang Won ◽  
Min Cheol Chang

AbstractObjectiveLittle is known about the effects of diabetes on motor recovery after cerebral infarct. To address this question, we recruited patients with corona radiata infarct and controlled for the integrity of the corticospinal tract (CST) as determined by diffusion tensor tractography (DTT).DesignOne hundred patients were recruited, and DTT was performed within 7 to 30 days of infarct onset. Based on the DTT findings (DTT+, CST was preserved around the infarct; DTT−, CST was interrupted by the infarct) and the presence (DM+) or absence (DM−) of diabetes, patients were divided into DTT+/DM− (36 patients), DTT+/DM+ (19 patients), DTT−/DM− (32 patients), and DTT−/DM+ (13 patients) groups. Six months after cerebral infarct, motor function on the affected side was evaluated for each patient via the upper motricity index (MI), lower MI, modified Brunnstrom classification (MBC), and functional ambulation category (FAC).ResultsIn the patients with a DTT+ finding, no motor function scores were significantly different between the DTT+/DM− and DTT+/DM+ groups at 6-month evaluation. However, in patients with DTT− finding, all motor function scores at the 6-month evaluation were significantly higher in the DTT−/DM− group than in the DTT−/DM+ group.ConclusionWhen the CST is interrupted by a corona radiata infarct, recovery of motor function in patients with diabetes is more impaired than those without diabetes.

NeuroImage ◽  
2009 ◽  
Vol 46 (3) ◽  
pp. 600-607 ◽  
Author(s):  
Adrian Imfeld ◽  
Mathias S. Oechslin ◽  
Martin Meyer ◽  
Thomas Loenneker ◽  
Lutz Jancke

2020 ◽  
Author(s):  
Bruno Shigueo Yonekura Inada ◽  
Thiago Junqueira Ribeiro Rezende ◽  
Fernando Vieira Pereira ◽  
Lucas Ávila Lessa Garcia ◽  
Antônio José da Rocha ◽  
...  

2016 ◽  
Vol 33 (1) ◽  
pp. 1-7 ◽  
Author(s):  
Sung Ho Jang ◽  
Ji Hyun Yi ◽  
Byung Yeon Choi ◽  
Chul Hoon Chang ◽  
Young Jin Jung ◽  
...  

2014 ◽  
Vol 2014 ◽  
pp. 1-5 ◽  
Author(s):  
Dongdong Rong ◽  
Miao Zhang ◽  
Qingfeng Ma ◽  
Jie Lu ◽  
Kuncheng Li

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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