Evidence of motor injury due to damaged corticospinal tract following acute hemorrhage in the basal ganglia region

Xiao Kun Fang,Zheng Qiu Zhu,Ling Shan Chen,Si Yuan Hou,Zhong Qiu Wang,Xue Hu Wei,Yong Kang Liu,Jing Li

doi:10.1038/s41598-020-73305-8

Abstract

The integrity of the corticospinal tract (CST) is significantly affected following basal ganglia haemorrhage. We aimed to assess the local features of CST and to effectively predict motor function by diffusion characteristics of CST in patients with motor injury following acute haemorrhage in the acute basal ganglia region. We recruited 37 patients with paresis of the lateral limbs caused by acute basal ganglia haemorrhage. Based on the automated fiber quantification method to track CST, assessed the character of each CST segment between the affected and contralateral sides, and correlated these with the Fugl–Meyer (FM) and Barthel Index (BI) scores at 6 months after onset. The fractional anisotropy (FA) values of the injured side of CST showed a significantly lower FA than the contralateral side along the tract profiles (p < 0.05, corrections for multiple comparisons). The FA values of each site at the internal capsule, closed corona radiata were positively correlated with the FM and BI score at 6 months after onset (p < 0.001, respectively). Our findings assessed the character of CST vividly in detail and dementated the primary sites of CST can predict the long-term outcome of motor function. This study may facilitate future clinical and cognitive studies of acute haemorrhage.

Highlights

The integrity of the corticospinal tract (CST) is significantly affected following basal ganglia haemorrhage
Haemorrhage in the region of the basal ganglia is a common cause of experiencing residual motor weakness or long-term disability[2,3], typically, neural injury by intracerebral haemorrhage (ICH) can result from a mass effect of hematoma and secondary injury of the peri-hematomal white matter due to increased intracranial pressure, decreased perfusion, and brain edema[4,5,6,7], such damage might result in abnormal diffusion of water. likely because ICH squeezes or destroys the motor function neural tract, the corticospinal tract (CST) which is the most important neural tract for motor control in the human brain[5,6,8]
Most previous studies are based on different methods to evaluate injury of lateral CST in patients with intracerebral haemorrhage[6,9,14,15,16] by manually placing regions of interest (ROIs), which may lead to inadequate repeatability and accuracy

Summary

Introduction

The integrity of the corticospinal tract (CST) is significantly affected following basal ganglia haemorrhage. We aimed to assess the local features of CST and to effectively predict motor function by diffusion characteristics of CST in patients with motor injury following acute haemorrhage in the acute basal ganglia region. To motor outcome, the most previous studies tried to draw different ROI and estimated the ROI’s diffusion character in the middle corona radiata, the posterior limb of the internal capsule, and the cerebral peduncle along the CST pathway[18,19,20,21]. We investigated the diffusion characteristics of CST in each small segment, based on the diffusion tensor imaging (DTI) method (Automated Fibre Quantification, AFQ) in 37 patients with acute basal ganglia haemorrhage, and evaluated the correlation between CST impairment and motor function score. Demonstrating the whole CST with detailed segments could be helpful to evaluate motor disability caused by acute basal ganglia haemorrhage and to improve the motor resilience during clinic treatment

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Conclusion