A systematic review of the usefulness of magnetic resonance imaging in predicting the gait ability of stroke patients

Takeshi Imura,Ryo Tanaka,Yuji Iwamoto,Tsubasa Mitsutake

doi:10.1038/s41598-021-93717-4

Abstract

The usefulness of magnetic resonance imaging (MRI) in predicting gait ability in stroke patients remains unclear. Therefore, MRI evaluations have not yet been standardized in stroke rehabilitation. We performed a systematic review to consolidate evidence regarding the use of MRIs in predicting gait ability of stroke patients. The Medline, Cumulative Index to Nursing and Allied Health Literature, and SCOPUS databases were comprehensively searched. We included all literature published from each source’s earliest date to August 2020. We included 19 studies: 8 were classified as structure- or function-based MRI studies and 11 as neural tract integrity-based MRI studies. Most structure- or function-based MRI studies indicated that damage to motor-related areas (primary motor cortex, corona radiata, internal capsule, and basal ganglia) or insula was related to poor gait recovery. In neural tract integrity-based MRI studies, integrity of the corticospinal tract was related to gait ability. Some studies reported predictive value of the corticoreticular pathway. All included studies had some concerns, at least one, based on the Cochrane risk of bias instrument. This review suggests that MRIs are useful in predicting gait ability of stroke patients. However, we cannot make definitive conclusion regarding the predictive value, due to the lack of quantitative evaluations.

Highlights

The usefulness of magnetic resonance imaging (MRI) in predicting gait ability in stroke patients remains unclear
Studies were included in this systematic review if they met following criteria: (1) the patients were diagnosed with hemorrhagic or ischemic strokes; (2) the patients had a conventional MRI (T1-weighted imaging, T2-weighted imaging, or fluid-attenuated inversion recovery), functional MRI, diffusion-weighted imaging (DWI), or diffusion tensor imaging (DTI); (3) gait ability outcomes were assessed; (4) the MRI was applied in predicting gait ability; (5) the study was a cohort study or case–control study; and (6) the article was written in English
The included studies were divided broadly into two research categories: (1) structure- or function-based MRI studies, which focused on affected brain structures or imaging findings; and (2) neural tract integrity-based MRI studies, which focused on neural tract integrity using DTI methodology

Summary

Introduction

The usefulness of magnetic resonance imaging (MRI) in predicting gait ability in stroke patients remains unclear. We performed a systematic review to consolidate evidence regarding the use of MRIs in predicting gait ability of stroke patients. This review suggests that MRIs are useful in predicting gait ability of stroke patients. Skilled clinicians who empirically understand the usefulness of brain imaging have already been applying it in routine patient evaluations, including to predict gait ability. No systematic review has evaluated the usefulness of MRIs in predicting the gait ability of stroke patients; as a result, MRI evaluations have not been standardized in the field of stroke rehabilitation. This systematic review aimed to consolidate evidence regarding the use of MRIs in predicting the stroke patient’s gait ability including the degree of gait independence, gait speed, or gait endurance

Methods

Results

Conclusion