Won Hyuk Chang1, Eunhee Park1, Jungsoo Lee1, Ahee Lee1, Yun-Hee Kim2. 1. From the Department of Physical and Rehabilitation Medicine, Center for Prevention and Rehabilitation, Heart Vascular Stroke Institute, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea (W.H.C., E.P., J.L., A.L., Y.-H.K.); and Department of Health Science and Technology (Y.-H.K.) and Department of Medical Device Management and Research (Y.-H.K.), Samsung Advanced Institute of Health Sciences and Technology, Sungkyunkwan University, Seoul, Korea. 2. From the Department of Physical and Rehabilitation Medicine, Center for Prevention and Rehabilitation, Heart Vascular Stroke Institute, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea (W.H.C., E.P., J.L., A.L., Y.-H.K.); and Department of Health Science and Technology (Y.-H.K.) and Department of Medical Device Management and Research (Y.-H.K.), Samsung Advanced Institute of Health Sciences and Technology, Sungkyunkwan University, Seoul, Korea. yunkim@skku.edu.
Abstract
BACKGROUND AND PURPOSE: The identification of intrinsic factors for predicting upper extremity motor outcome could aid the design of individualized treatment plans in stroke rehabilitation. The aim of this study was to identify prognostic factors, including intrinsic genetic factors, for upper extremity motor outcome in patients with subacute stroke. METHODS: A total of 97 patients with subacute stroke were enrolled. Upper limb motor impairment was scored according to the upper limb of Fugl-Meyer assessment score at 3 months after stroke. The prediction of upper extremity motor outcome at 3 months was modeled using various factors that could potentially influence this impairment, including patient characteristics, baseline upper extremity motor impairment, functional and structural integrity of the corticospinal tract, and brain-derived neurotrophic factor genotype. Multivariate ordinal logistic regression models were used to identify the significance of each factor. RESULTS: The independent predictors of motor outcome at 3 months were baseline upper extremity motor impairment, age, stroke type, and corticospinal tract functional integrity in all stroke patients. However, in the group with severe motor impairment at baseline (upper limb score of Fugl-Meyer assessment <25), the number of Met alleles in the brain-derived neurotrophic factor genotype was also an independent predictor of upper extremity motor outcome 3 months after stroke. CONCLUSIONS: Brain-derived neurotrophic factor genotype may be a potentially useful predictor of upper extremity motor outcome in patients with subacute stroke with severe baseline motor involvement.
BACKGROUND AND PURPOSE: The identification of intrinsic factors for predicting upper extremity motor outcome could aid the design of individualized treatment plans in stroke rehabilitation. The aim of this study was to identify prognostic factors, including intrinsic genetic factors, for upper extremity motor outcome in patients with subacute stroke. METHODS: A total of 97 patients with subacute stroke were enrolled. Upper limb motor impairment was scored according to the upper limb of Fugl-Meyer assessment score at 3 months after stroke. The prediction of upper extremity motor outcome at 3 months was modeled using various factors that could potentially influence this impairment, including patient characteristics, baseline upper extremity motor impairment, functional and structural integrity of the corticospinal tract, and brain-derived neurotrophic factor genotype. Multivariate ordinal logistic regression models were used to identify the significance of each factor. RESULTS: The independent predictors of motor outcome at 3 months were baseline upper extremity motor impairment, age, stroke type, and corticospinal tract functional integrity in all strokepatients. However, in the group with severe motor impairment at baseline (upper limb score of Fugl-Meyer assessment <25), the number of Met alleles in the brain-derived neurotrophic factor genotype was also an independent predictor of upper extremity motor outcome 3 months after stroke. CONCLUSIONS:Brain-derived neurotrophic factor genotype may be a potentially useful predictor of upper extremity motor outcome in patients with subacute stroke with severe baseline motor involvement.
Authors: Michael A Dimyan; Stacey Harcum; Elsa Ermer; Amy F Boos; Susan S Conroy; Fang Liu; Linda B Horn; Huichun Xu; Min Zhan; Hegang Chen; Jill Whitall; George F Wittenberg Journal: Neurorehabil Neural Repair Date: 2022-05-26 Impact factor: 4.895
Authors: Stacey Harcum; Susan S Conroy; Amy Boos; Elsa Ermer; Huichun Xu; Min Zhan; Hegang Chen; Jill Whitall; Michael A Dimyan; George F Wittenberg Journal: Arch Rehabil Res Clin Transl Date: 2019-09-10