Integrity of The Hand Fibers of The Corticospinal Tract Shown by Diffusion Tensor Imaging Predicts Hand Function Recovery After Hemorrhagic Stroke

Abstract

BackgroundHand motor function is often severely affected in patients with hemorrhagic stroke. The present study aimed to investigate the feasibility of predicting hand function recovery after hypertensive intracerebral hemorrhage using diffusion tensor imaging (DTI). MethodsA total of 75 patients with hypertensive intracerebral hemorrhage were prospectively included. DTI of the corticospinal tract (CST) connecting the hand knob area of the precentral gyrus and the cerebral peduncle was performed at around 3 weeks after stroke. Integrity of the CST was evaluated as no disruption, partial disruption, and complete disruption. Hand function was compared by the Brunnstrom recovery stage of hand (BRS-H) at post-stroke 3 weeks and 3 months. ResultsDegrees of integrity of the corticospinal cord was negatively correlated with the BRS-H at both post-stroke 3 weeks (r = -0.77, p < 0.01) and 3 months (r = -0.75, p < 0.01). Patients with intact CST or completely disrupted CST shown by DTI did not show significant improvement in the BRS-H at post-stroke 3 months. However, those with partially disrupted CST showed significant improvement in the BRS-H at post-stroke 3 months compared to 3 weeks (3.79 ± 1.36 vs 2.53 ± 1.58, p = 0.012). ConclusionsDTI can be used to visualize the damage to the hand fibers of the CST. Patients with partially disrupted CST may benefit most from rehabilitation therapy for hand function recovery after hypertensive intracerebral hemorrhage.