Prediction of Motor Recovery in Patients with Basal Ganglia Hemorrhage Using Diffusion Tensor Imaging.

Yu-Sun Min,Yu-Sun Min,Yu-Sun Min,Tae-Du Jung,Tae-Du Jung,Youn-Soo Cheong,Eunhee Park,Eunhee Park,Ju-Hyun Kim,Kyung Eun Jang,Jaechan Park,Min-Gu Kang,Ae-Ryoung Kim,Ae-Ryoung Kim,Seung-Hwan Jung

doi:10.3390/jcm9051304

Abstract

Predicting prognosis in patients with basal ganglia hemorrhage is difficult. This study aimed to investigate the usefulness of diffusion tensor imaging in predicting motor outcome after basal ganglia hemorrhage. A total of 12 patients with putaminal hemorrhage were included in the study (aged 50 ± 12 years), 8 patients were male (aged 46 ± 11 years) and 4 were female (aged 59 ± 9 years). We performed diffusion tensor imaging and measured clinical outcome at baseline (pre) and 3 weeks (post1), 3 months (post2), and 6 months (post3) after the initial treatment. In the affected side of the brain, the mean fractional anisotropy (FA) value on pons was significantly higher in the good outcome group than that in the poor outcome group at pre (p = 0.004) and post3 (p = 0.025). Pearson correlation analysis showed that mean FA value at pre significantly correlated with the sum of the Brunnstrom motor recovery stage scores at post3 (R = 0.8, p = 0.002). Change in the FA ratio on diffusion tractography can predict motor recovery after hemorrhagic stroke.

Highlights

Prediction of prognosis in patients with hemorrhagic stroke is difficult but important when planning and designing an individual patient’s rehabilitation strategy [1]
Growing evidence shows the potential of diffusion tensor imaging (DTI) as a noninvasive magnetic resonance imaging (MRI) technique for in vivo quantification of microstructural damage to white matter (WM) tracts following stroke [12]
Kusano et al demonstrated that relative fractional anisotropy can reflect prognosis [21]

Summary

Introduction

Prediction of prognosis in patients with hemorrhagic stroke is difficult but important when planning and designing an individual patient’s rehabilitation strategy [1]. Many studies have used clinical features and neurophysiological findings to predict prognosis, such as the Predict Recovery Potential (PREP) model, which is based on the proportional recovery theory [2,3]. Most of these studies investigated patients with ischemic stroke rather than hemorrhagic stroke [4,5]. Growing evidence shows the potential of diffusion tensor imaging (DTI) as a noninvasive magnetic resonance imaging (MRI) technique for in vivo quantification of microstructural damage to white matter (WM) tracts following stroke [12]. Because the value of FA has been extensively used in previous studies, it is more appropriate to compare the results between studies

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