Journal of Biomedical Engineering Research (대한의용생체공학회:의공학회지)

The Korean Society of Medical and Biological Engineering (대한의용생체공학회)
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Applications of Diffusion Tensor MRI to Predict Motor Recovery of Stroke Patients in the Chronic Stages

  • Tae, Ki-Sik (Dept. of Biomedical Engineering, Konyang University) ;
  • Song, Sung-Jae (Dept. of Mechanical Engineering, Kangnung University) ;
  • Kim, Young-Ho (Dept. of Biomedical Engineering, Yonsei University)
  • Published : 2008.04.30
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Abstract

Within 2 to 5 months after stroke, patients recover variable degrees of function, depending on the initial deficit. An impaired hand function is one of the most serious disability in chronic stroke patients. Therefore, to evaluate the extent of motor dysfunction in the hemiplegic hand is important in stroke rehabilitation. In this paper, motor recoveries in 8 chronic stroke patients with Fugl-Meyer (FM) and white matter changes before and after the training program with a designed bilateral symmetrical arm trainer (BSAT) system were examined. The training was performed at 1 hr/day, 5 days/week during 6weeks. In all patients, FM was significantly improved after the 6-week training. Diffusion tensor imaging (DTI) results showed that tractional anisotropy ratio (FAR) and fiber tracking ratio (FTR) in the posterior internal capsule were significantly increased after the training. It seemed that the cortical reorganization was induced by the 6 week training with the BSAT. In all parameters proposed this study, a significant correlation was found between these parameters (FAR and FTR) and motor recoveries. This study demonstrated that DTI technique could be useful in predicting motor recovery in chronic hemiparetic patients.

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References

  1. E.B. Murray and V.B. John, Stroke Rehabilitation, NY, USA: Williams & Wilkins, pp. 34-36, 1987
  2. S.J. Fellows, C. Kaus and H.F. Ross, 'Agonist and antagonist EMG activation during isometric torque development at the elbow in spastic hemiparesis', Electroencephal Clin Neurophsiol., vol. 93, pp. 106-112, 1994 https://doi.org/10.1016/0168-5597(94)90073-6
  3. J. Whitall, S. Waller and K. Silver, 2000. 'Repetitive bilateral arm training with rhythmic auditory cueing improves motor function in chronic hemiparetic stroke', Stroke, vol. 31, pp. 2390-2395, 2000 https://doi.org/10.1161/01.STR.31.10.2390
  4. C. Beulieu, 'The basis of anisotropy water diffusion in the nervous system-a technical review', NMR Biomed., vol. 15, pp. 435-455, 2002 https://doi.org/10.1002/nbm.782
  5. D. Le Bihan, J.F. Mangin and C. Poupon, 'Diffusion tensor imaging: conceps and applications', J Magn Reson Imaging., vol. 13, pp. 534-536, 2001 https://doi.org/10.1002/jmri.1076
  6. C.H. Sotak, 'The role of diffusion tensor imaging in the evaluation of ischemic brain injury-a review', NMR Biomed., vol. 15, pp. 561-569, 2002 https://doi.org/10.1002/nbm.786
  7. D.J. Werring, A.T. Toosy and C.A. Clark, 'Diffusion tensor imaging can detect and quantify corticospinal tract degeneration after stroke', J Neurol Neurosurg Phychiatry., vol. 69, pp. 269-272, 2000 https://doi.org/10.1136/jnnp.69.2.269
  8. K.S. Tae, S.J. Song, B.S. Han, S.Y. Lee, G.Y. Park, C.H. Sohn, H.S. Jeon, M.S, Choi and Y.H. Kim, 'Diffusion Tensor Imaging in Patients with Thalamic Hemorrhage: Correlations between Diffusion Anisotropy and Motor Recovery', Key Eng. Materials., vol. 326, pp. 895-898, 2006 https://doi.org/10.4028/www.scientific.net/KEM.326-328.895
  9. E.R. Melhem, S. Mori and G. Mukundan, 'Diffusion tensor MR imaging of the brain and white matter tractography', Am J Roentgenol., vol. 178, pp. 3-16, 2002 https://doi.org/10.2214/ajr.178.1.1780003
  10. A.G. Sorensen, O, Wu and W.A. Copen, 'Human acute cerebral ishchemia: detection of changes in water diffusion anisotropy by using MR imaging', Radiology., vol. 212, pp. 785-792, 1991
  11. J.S. Shimony, R.C. McKinstry and E. Akbudak, 'Quantitative diffusion tensor anisotropy brain MR imaging: human data and anatomic analysis', Radiology., vol. 212, pp. 770-784, 1999 https://doi.org/10.1148/radiology.212.3.r99au51770
  12. P.W. Ducan, M. Propst and S.G. Nelson, 'Reliability of the Fugl-Meyer assessment of sensorimotor recovery following cerebrovascular accident', Phys Ther., vol. 63, pp. 1606-1610, 1983 https://doi.org/10.1093/ptj/63.10.1606
  13. S. Mori, W.E. Kaifmann, C. Davatzikos, B. Stieltjes, L. Amodei and M. Solaiyappan, 'Imaging cortical association tracts in the human brain using diffusion-tensor-based axonal tracking', Magn. Reson. Med., vol. 47, pp. 213-215, 2002 https://doi.org/10.1002/mrm.10056
  14. A. Kunimatsu, S. Aoki, Y. Masutani, O. Abe, N. Hayashi, H. Mori and K. Ohtomo, 'The optimal trakability threshold of fractioanl anisotropy for diffusion tendor tractography of the corticospinal tract', Magn. Reson. Med. Sci., vol. 3, pp. 11-17, 2004 https://doi.org/10.2463/mrms.3.11
  15. U.C. Wieshmann, C.A. Clark and M.R. Symms, 'Anisotropy of water diffusion in corona radiata and cerebral peduncle in patients with hemiparesis', Neuroimage., vol. 10, pp. 225-230, 1999 https://doi.org/10.1006/nimg.1999.0456
  16. T. Watanabe, Y. Honda and Y. Fujii, 'Three-dimensional anisotropy contrast magnetic resonance axonography to predict the prognosis for motor function in patients suffering from stroke', J Neurosurg., vol. 94, pp. 955-960, 2001 https://doi.org/10.3171/jns.2001.94.6.0955
  17. Q. Yang, B.M. Tress and P.A. Barber, 'Serial study of apparent diffusion coefficient and anisotropy in patients with acute stroke', Stroke., vol. 30, pp. 2382-2390, 1999 https://doi.org/10.1161/01.STR.30.11.2382
  18. V.J. Schmithost and M. Wilke, 'Differences in white matter architecture between musicians and non-musicians: a diffusion tensor imaging study', Neurosci Lett., vol. 321, pp. 57-60, 2002 https://doi.org/10.1016/S0304-3940(02)00054-X
  19. S.H. Jang, S.H, Cho, Y.H. Kim, B.S. Han, W.M. Byun, S.M. Son, S.H. Kim and S.J. Lee, 'Diffusion anisotropy in the early stages of stroke can predict motor outcome', Rest Neurol and Neurosci., vol. 23, pp. 11-17, 2005
  20. H.C. Cho, E.I. Son, S.Y. Lee, G.Y. Park, C.H. S ohn and M.B. Lim, 'Analysis of corticospinal tract injury by using the diffusion tensor imaging of 3.0T magnetic resonance in patients with hypertensive intracerebral hemorhage', J Korean Neurosur Soc., vol. 38, pp. 331-337, 2005
  21. S. Mori, K. Frederiksen and P.C. van Ziji, 'Brain white matter anatomy of tumor patients evaluated with diffusion tensor imaging', Ann Neurol., vol. 5, pp. 377-380, 2002
  22. A. Kunimatsu, S. Aoki, Y. Masutani, O. Abe, H. Mori and K. Ohtomo, 'Three-dimensional white matter tractography by diffusion tensor imaging in ischemic stroke involving the corticospinal tract', Diagnostic Neurol., vol. 45, pp. 532-535, 2003