scholarly journals Relationship between the Corticospinal and Corticocerebellar Tracts and Their Role in Upper Extremity Motor Recovery in Stroke Patients

2021 ◽  
Vol 11 (11) ◽  
pp. 1162
Author(s):  
Jungsoo Lee ◽  
Won Hyuk Chang ◽  
Yun-Hee Kim
Keyword(s):  
Upper Extremity ◽  
Predictive Accuracy ◽  
Diffusion Tensor ◽  
Stroke Onset ◽  
Patient Specific ◽  
Stroke Patients ◽  
Predictive Values ◽  
The Relationship ◽  
Diffusion Tensor Imaging Dti

The corticospinal tract (CST) and corticocerebellar tract (CCT) are both involved in the upper extremity (UE) function after stroke. Understanding the relationship between the tracts and their functions can contribute to developing patient-specific rehabilitative strategies. Seventy ischemic stroke patients who underwent diffusion tensor imaging (DTI) two weeks after the stroke onset and motor function assessments two weeks and three months after the stroke onset were included in this study. To obtain the CST and CCT integrity, the functional anisotropy (FA) values of both tracts were extracted from the DTI data. Linear regression was used to identify the relationship and predictive accuracy. The CST FA data had predictive values, but CCT FA did not. There were interaction effects between the CST and CCT FA values (p = 0.011). The CCT was significantly associated with high CST FA but not low CST FA. When the CST or CCT FA were applied to patients depending on the CST status, the stratified model showed higher predictive accuracy (R2 = 0.380) than that of the CST-only model (R2 = 0.320). In this study, the conditional role of CCT depending on CST status was identified in terms of UE recovery in stroke patients. This result could provide useful information about individualized rehabilitative strategies in stroke patients.

scholarly journals White matter abnormalities of corpus callosum in patients with bipolar disorder and suicidal ideation

2019 ◽  
Vol 18 (1) ◽  
Author(s):  
Ran Zhang ◽  
Xiaowei Jiang ◽  
Miao Chang ◽  
Shengnan Wei ◽  
Yanqing Tang ◽  
...  
Keyword(s):  
Bipolar Disorder ◽  
White Matter ◽  
Suicidal Ideation ◽  
Corpus Callosum ◽  
Diffusion Tensor ◽  
The Body ◽  
Pathophysiological Mechanism ◽  
The Relationship ◽  
Diffusion Tensor Imaging Dti

Abstract Objective Although many studies have shown that the corpus callosum (CC) may play an important role in bipolar disorder (BD) and suicide, the pathophysiological mechanism of BD underlying suicidal behavior is still unclear. This study aimed to explore the relationship between the CC, and BD and suicidal ideation using diffusion tensor imaging (DTI). Method A total of 203 participants (47 BD patients with suicidal ideation, 59 with BD without suicidal ideation, and 97 healthy controls [HC]) underwent DTI scanning at a single site. We examined the white matter integrity of the CC in the three groups. Results A comparison among groups showed that BD patients with suicidal ideation had significant lower fractional anisotropy (FA) values than those of BD without suicidal ideation and HCs in the body and genu of the CC, and FA values of BD without suicidal ideation were significantly lower than those of HCs. However, in the splenium of corpus callosum, no difference was found between BD without suicidal ideation and HCs. Conclusions Our findings add to the evidence suggesting that the CC plays a key role in BD with suicidal ideation, especially with respect to the role of the genu and body of the CC subserving emotion regulation.

scholarly journals Does Motor Tract Integrity at 1 Month Predict Gait and Balance Outcomes at 6 Months in Stroke Patients?

2021 ◽  
Vol 11 (7) ◽  
pp. 867
Author(s):  
SoYeon Jun ◽  
BoYoung Hong ◽  
YoungKook Kim ◽  
SeongHoon Lim
Keyword(s):  
White Matter ◽  
Corticospinal Tract ◽  
Diffusion Tensor ◽  
Berg Balance Scale ◽  
Stroke Onset ◽  
Stroke Patients ◽  
Fiber Number ◽  
Gait Function ◽  
Corticoreticular Pathway

Recovery of balance and gait ability is important in stroke patients. Several studies have examined the role of white matter tracts in the recovery of gait and balance, but the results have been inconclusive. Therefore, we examined whether the integrity of the corticospinal tract (CST), corticoreticular pathway (CRP), and cortico-ponto-cerebellar tract (CPCT) at 1 month predicted balance and gait function 6 months after stroke onset. This retrospective longitudinal observational clinical study assessed 27 patients with first-ever unilateral supratentorial stroke. The subjects underwent diffusion tensor imaging 1 month after the stroke, and the Functional Ambulation Categories (FAC) and Berg Balance Scale (BBS) scores were assessed after 6 months. The normalized fiber number (FN) and fractional anisotropy (FA) results for the CST, CRP and CPCT were also obtained. The FN and FA results for the CST, CRP, or CPCT at 1 month were not related to the gait or balance at 6 months. There was also no difference in FAC values at 1 month after stoke onset among three groups differing in degree of independence of ambulation. The integrity of the CST, CRP, and CPCT on 1 month after stroke onset was not associated with gait or balance after 6 months. The white matter integrity did not predict the clinical outcome.

Abstract 2580: How Frequent Is Impaired Arm And Hand Function After First Occasion Of Stroke? An Unselected Population From A Stroke Unit With A Geographical Catchment.

Stroke ◽  
2012 ◽  
Vol 43 (suppl_1) ◽  
Author(s):  
Katharina Stibrant Sunnerhagen ◽  
Hanna C Persson
Keyword(s):  
Upper Extremity ◽  
Stroke Unit ◽  
Catchment Area ◽  
Hand Function ◽  
Stroke Onset ◽  
Stroke Patients ◽  
Extremity Function ◽  
Unselected Population ◽  
Upper Extremity Function ◽  
Impaired Motor Function

Introduction Reduced upper extremity function after stroke has previously been reported in 70-80% of patients with stroke in the acute stage and is one of the most common impairments after acute stroke impaired motor function, both in upper and lower extremity, influence the stroke unit care and planning of the rehabilitation, partly due to the economic costs. There is limited information in upper extremity function within the first days after a stroke. Prior studies include either both first and recurrent stroke or only one type of stroke. Objectives To investigate the frequency impaired arm and hand function in an unselected group of patients with first occasion of stroke. Method All patients at a stroke unit at Sahlgrenska University Hospital were assessed during 18 months. From the hospital records, the patients were identified, the patient charts were read and first stroke diagnosis was confirmed (by either imaging or clinical assessment). Impaired upper extremity function was defined in the following manner: assessed with the Modified Motor Assessment Scale (M-MAS UAS -95) by physiotherapist working at the stroke unit within 72 hours after stroke onset or if this was found in the patients chart, other standardized assessments of upper extremity function performed by the physical therapist, the occupational therapist or the physicians on the ward. Results During the study period 984 patients with first ever stroke (438 women 44.5%) were admitted to the stroke unit. A total of 213 patients were not at the stroke unit within 72 hours after onset and therefore excluded; 90 patients had unclear stroke onset time, 49 patients were located at another ward, 36 patients were in the intensive care unit, 25 in other hospitals in Sweden and 12 patients were hospitalized in another country. There were 771 patients over 18 years old at the stroke unit within 72 hours after stroke onset. Of these 56 patients (7.3%), were not living in the catchment area and therefore excluded. Of the 715 patients living in the geographical catchment area, 58, (8.1%) hade other upper extremity injury prior the stroke onset. Of the remaining first ever stroke patients (n=657), 311 patients (47.3%) hade impaired arm and hand function within 72 hours after stroke onset. Conclusion The frequency of impaired upper extremity function in this unselected population of first occasion of stroke is lower than previously reported. The Copenhagen stroke study noted 69 % impaired at admission and 43 % at one week. This indicates that today’s stroke patients present less frequent with impaired motor function in the upper extremity. However, they may have difficulties in functional activities which may influence content of rehabilitation process.

scholarly journals Application of multishot diffusion tensor imaging in spinal cord tumors

2019 ◽  
Vol 5 (1) ◽  
pp. 59-64
Author(s):  
Jiefei Li ◽  
Le He ◽  
Yuqi Zhang
Keyword(s):  
Spinal Cord ◽  
Diffusion Tensor Imaging ◽  
Diffusion Tensor ◽  
Preoperative Imaging ◽  
Spinal Cord Tumors ◽  
Intramedullary Tumors ◽  
Routine Magnetic Resonance Imaging ◽  
Relationship Of ◽  
The Relationship ◽  
Diffusion Tensor Imaging Dti

Objective: To explore the usefulness of multishot diffusion tensor imaging (DTI) for evaluating the neurological function of patients with spinal cord tumors Methods: Routine magnetic resonance imaging and multishot DTI were performed in five patients with spinal cord tumors. The values of fractional anisotropy (FA) and radial diffusivity (RD) were analyzed. Results: Multishot DTI of spinal cord tumors allowed for defining the margins of tumors and determining the relationship of tumors with the adjacent white matter structures of the spinal cord. Multishot DTI demonstrated significantly increased RD and decreased FA of spinal cord tumors compared with those of the normal spinal cord. Conclusions: Multishot DTI is a potentially useful modality for differentiating resectable tumors from nonresectable ones based on preoperative imaging alone as well as for differentiating intramedullary tumors from extramedullary ones. Further prospective studies are warranted to confirm these results.

The Role of Duplex Ultrasound in the Detection of Upper Extremity Artery Pathology, and Post Endovascular Complications

2018 ◽  
Vol 42 (1) ◽  
pp. 26-29
Author(s):  
Jason Roberts ◽  
Vaqar Ali ◽  
Mian Ahmed Hasan
Keyword(s):  
Upper Extremity ◽  
Fibromuscular Dysplasia ◽  
Duplex Ultrasound ◽  
Limb Ischemia ◽  
Arterial Disease ◽  
Upper Extremities ◽  
Peripheral Arterial ◽  
The Relationship ◽  
Abnormal Pathology

Upper extremity pathology is uncommon and generally involves the brachial artery in about 12% of the cases. Of chronic upper limb ischemia, trauma, fibromuscular dysplasia, giant cell arteritis, and atherosclerosis are among the most reported cases. After a thorough review of the literature, there is agreement with duplex ultrasound sensitivity and specificity for predicting >70% stenosis in the subclavian arteries with a sensitivity of >82% and specificity of >90%. This article not only correlates the relationship between duplex ultrasound and severe peripheral arterial disease, but it also proves with 100% accuracy the ability to detect latent and abnormal pathology of the upper extremities post endovascular intervention.

Abnormalities in the white matter tracts in patients with Parkinson disease and psychosis

Neurology ◽  
2020 ◽  
Vol 94 (18) ◽  
pp. e1876-e1884 ◽  
Author(s):  
Abhishek Lenka ◽  
Madhura Ingalhalikar ◽  
Apurva Shah ◽  
Jitender Saini ◽  
Shyam Sundar Arumugham ◽  
...  
Keyword(s):  
White Matter ◽  
Parkinson Disease ◽  
Diffusion Tensor ◽  
Cross Sectional Study ◽  
Cross Sectional ◽  
Inferior Longitudinal Fasciculus ◽  
Microstructural Integrity ◽  
Tesla Scanner ◽  
Diffusion Tensor Imaging Dti

ObjectiveThe objective of the current study was to compare the microstructural integrity of the white matter (WM) tracts in patients having Parkinson disease (PD) with and without psychosis (PD-P and PD-NP) through diffusion tensor imaging (DTI).MethodsThis cross-sectional study involved 48 PD-NP and 42 PD-P who were matched for age, sex, and education. Tract-based spatial statistics (TBSS) was used to compare several DTI metrics from the diffusion-weighted MRIs obtained through a 3-Tesla scanner. A set of neuropsychological tests was used for the cognitive evaluation of all patients.ResultsThe severity and stage of PD were not statistically different between the groups. The PD-P group performed poorly in all the neuropsychological domains compared with the PD-NP group. TBSS analysis revealed widespread patterns of abnormality in the fractional anisotropy (FA) in the PD-P group, which also correlated with some of the cognitive scores. These tracts include inferior longitudinal fasciculus, inferior fronto-occipital fasciculus, right parieto-occipital WM, body of the corpus callosum, and corticospinal tract.ConclusionThis study provides novel insights into the putative role of WM tract abnormalities in the pathogenesis of PD-P by demonstrating significant alterations in several WM tracts. Additional longitudinal studies are warranted to confirm the findings of our research.

scholarly journals Somatosensory and Brainstem Auditory Evoked Potentials Assessed between 4 and 7 Days after Severe Stroke Onset Predict Unfavorable Outcome

2015 ◽  
Vol 2015 ◽  
pp. 1-6
Author(s):  
Yan Zhang ◽  
Ying Ying Su ◽  
Shu Ying Xiao ◽  
Yi Fei Liu
Keyword(s):  
Evoked Potentials ◽  
Prognostic Value ◽  
Auditory Evoked Potentials ◽  
Early Stage ◽  
Stroke Onset ◽  
Modified Rankin Scale ◽  
Brainstem Auditory Evoked Potentials ◽  
Stroke Patients ◽  
Predictive Values ◽  
Severe Stroke

Our objective was to explore the best predictive timing of short-latency somatosensory evoked potentials (SLSEP) and brainstem auditory evoked potentials (BAEP) for unfavorable outcomes in patients with early stage severe stroke. One hundred fifty-six patients with acute severe supratentorial stroke were monitored according to SLSEP, BAEP, and the Glasgow Coma Scale (GCS) at 1–3 days and 4–7 days after the onset of stroke. All patients were followed up for outcomes at 6 months after onset using the modified Rankin Scale (mRS), with a score of 5-6 considered unfavorable. The predictive values of SLSEP, BAEP, and the GCS at 1–3 days were compared with 4–7 days after onset. Our results show that, according to the analysis of prognostic authenticity, the predictive values of SLSEP and BAEP at 4–7 days after stroke onset improved when compared with the values at 1–3 days for unfavorable outcomes. Most of the patients with change of worsening evoked potentials from 1–3 days to 4–7 days after onset had unfavorable outcomes. In conclusion, SLSEP and BAEP assessed at 4–7 days after onset predicted unfavorable outcomes for acute severe stroke patients. The worsening values of SLSEP and BAEP between 1–3 days and 4–7 days also present a prognostic value.

scholarly journals Value of examination of the gastric aspirate for the diagnosis of neonatal infection

2018 ◽  
Vol 5 (6) ◽  
pp. 2309
Author(s):  
Meetu Yadav ◽  
Raksha Gupta ◽  
Jasbir Singh ◽  
Sameer Saraswath ◽  
Niranjan Nagaraj ◽  
...  
Keyword(s):  
Predictive Accuracy ◽  
Mode Of Delivery ◽  
Neonatal Morbidity ◽  
Neonatal Infection ◽  
Gastric Aspirate ◽  
Maternal Risk ◽  
Sepsis Screening ◽  
Relationship Of ◽  
The Relationship

Background: Infections in early neonatal period are one of the important factors responsible for high perinatal mortality and neonatal morbidity in developing countries. This study aims to know the role of Gastric aspirates cytology in predicting the early septicemia in newborn babies.Methods: The study will be conducted on 100 neonates with suspected septicemia and 50 normal neonates admitted to neonatology section. Gastric aspirate sample was collected for   sepsis screening of neonates. All the collected data was tabulated and statistically analysed by using SPSS 2.0 software.Results: The sensitivity of gastric aspirate cytology is 50%, specificity 65.62%, positive predictive accuracy 47.6%, negative predictive accuracy of 67. 7%. The relationship between gastric aspirate cytology and maternal risk factors was found to be statistically not significant except PIH and PROM in which association is significant. The relationship of prolonged rupture of membranes with gastric aspirate cytology was found to be highly statistically significant.Conclusions: The chances of positivity of gastric aspirate increase as the duration of rupture of membranes increased. Gastric aspirate had high percentage of specificity and negative predictive accuracy. No specific and significant correlation between positive gastric aspirate cytology and rural/urban area, birth weight, sex, gestation, prolong labour, meconium stained amniotic fluid, mode of delivery was found.

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