Julie Soulard1, Coline Huber1, Sebastien Baillieul1, Antoine Thuriot1, Felix Renard1, Bérengère Aubert Broche1, Alexandre Krainik1, Nicolas Vuillerme1, Assia Jaillard2. 1. From the Université Grenoble Alpes (J.S., A.T., F.R., A.B.B., N.V., A.J.), AGEIS, Faculté de Médecine; Stroke Unit (J.S., A.T.), Neurologie, Centre Hospitalier Universitaire Grenoble Alpes (CHUGA); Unité IRM 3T-Recherche-UMS IRMaGe-CHUGA (C.H., A.K., A.J.); IRMaGe-Inserm US-017 (C.H., A.K.), CNRS UMS-3552, UGA, Grenoble; Neuroradiologie-IRM-Pôle Imagerie-CHUGA (A.K.); Centre Hospitalier Métropole Savoie (C.H.), Chambéry; Laboratoire HP2 (S.B.), UGA; Pôle thorax et vaisseaux, CHUGA; Pôle Recherche (A.J.), CHUGA, Grenoble; and Institut Universitaire de France (N.V.), Paris, France. 2. From the Université Grenoble Alpes (J.S., A.T., F.R., A.B.B., N.V., A.J.), AGEIS, Faculté de Médecine; Stroke Unit (J.S., A.T.), Neurologie, Centre Hospitalier Universitaire Grenoble Alpes (CHUGA); Unité IRM 3T-Recherche-UMS IRMaGe-CHUGA (C.H., A.K., A.J.); IRMaGe-Inserm US-017 (C.H., A.K.), CNRS UMS-3552, UGA, Grenoble; Neuroradiologie-IRM-Pôle Imagerie-CHUGA (A.K.); Centre Hospitalier Métropole Savoie (C.H.), Chambéry; Laboratoire HP2 (S.B.), UGA; Pôle thorax et vaisseaux, CHUGA; Pôle Recherche (A.J.), CHUGA, Grenoble; and Institut Universitaire de France (N.V.), Paris, France. Assia.Jaillard@univ-grenoble-alpes.fr.
Abstract
OBJECTIVE: To identify candidate biomarkers of walking recovery with motor tract integrity measurements using fractional anisotropy (FA) from the corticospinal tract (CST) and alternative motor pathways in patients with moderate to severe subacute stroke. METHODS: Walking recovery was first assessed with generalized linear mixed model (GLMM) with repeated measures of walking scores (WS) over 2 years of follow-up in a longitudinal study of 29 patients with subacute ischemic stroke. Baseline FA measures from the ipsilesional and contralesional CST (i-CST and c-CST), cortico-reticulospinal pathway (i-CRP and c-CRP), and cerebellar peduncles were derived from a 60-direction diffusion MRI sequence on a 3T scanner. We performed correlation tests between WS and FA measures. Third, we investigated using GLMM whether motor tract integrity contributes to predict walking recovery. RESULTS: We observed significant improvements of WS over time with a plateau reached at ≈6 months after stroke. WS significantly correlated with FA measures from i-CST, c-CST, i-CRP, and bilateral cerebellar peduncles. Walking recovery was predicted by FA measures from 3 tracts: i-CST, i-CRP, and contralesional superior cerebellar peduncle (c-SCP). Diffusion tensor imaging (DTI) predictors captured 80.5% of the unexplained variance of the model without DTI. CONCLUSIONS: We identified i-CST and alternative motor-related tracts (namely i-CRP and c-SCP) as candidate biomarkers of walking recovery. The role of the SCP in walk recovery may rely on cerebellar nuclei projections to the thalamus, red nucleus, and reticular formation. Our findings suggest that a set of white matter tracts, part of subcortical motor networks, contribute to walking recovery in patients with moderate to severe stroke.
OBJECTIVE: To identify candidate biomarkers of walking recovery with motor tract integrity measurements using fractional anisotropy (FA) from the corticospinal tract (CST) and alternative motor pathways in patients with moderate to severe subacute stroke. METHODS: Walking recovery was first assessed with generalized linear mixed model (GLMM) with repeated measures of walking scores (WS) over 2 years of follow-up in a longitudinal study of 29 patients with subacute ischemic stroke. Baseline FA measures from the ipsilesional and contralesional CST (i-CST and c-CST), cortico-reticulospinal pathway (i-CRP and c-CRP), and cerebellar peduncles were derived from a 60-direction diffusion MRI sequence on a 3T scanner. We performed correlation tests between WS and FA measures. Third, we investigated using GLMM whether motor tract integrity contributes to predict walking recovery. RESULTS: We observed significant improvements of WS over time with a plateau reached at ≈6 months after stroke. WS significantly correlated with FA measures from i-CST, c-CST, i-CRP, and bilateral cerebellar peduncles. Walking recovery was predicted by FA measures from 3 tracts: i-CST, i-CRP, and contralesional superior cerebellar peduncle (c-SCP). Diffusion tensor imaging (DTI) predictors captured 80.5% of the unexplained variance of the model without DTI. CONCLUSIONS: We identified i-CST and alternative motor-related tracts (namely i-CRP and c-SCP) as candidate biomarkers of walking recovery. The role of the SCP in walk recovery may rely on cerebellar nuclei projections to the thalamus, red nucleus, and reticular formation. Our findings suggest that a set of white matter tracts, part of subcortical motor networks, contribute to walking recovery in patients with moderate to severe stroke.
Authors: Jasmin D Sanchez; Richard A Martirosian; Katherine T Mun; Davis S Chong; Irene Lorenzo Llorente; Timo Uphaus; Klaus Gröschel; Teresa A Wölfer; Steffen Tiedt; Jason D Hinman Journal: Front Neurol Date: 2022-05-16 Impact factor: 4.086
Authors: Denise M Peters; Julius Fridriksson; Jessica D Richardson; Jill C Stewart; Chris Rorden; Leonardo Bonilha; Addie Middleton; Stacy L Fritz Journal: Behav Neurol Date: 2021-11-11 Impact factor: 3.342