Abstract Details

Title Quantitative Assessment of Corticospinal Tract Injury on Diffusion Tensor Imaging Correlates with Motor Outcome after Ischemic Stroke

Topic Cerebrovascular Disease and Interventional Neurology

Presentation(s) P03 - (-)

Poster/Presentation
Number 163

Objective

Background BACKGROUND: Motor impairment is the leading form of disability after ischemic stroke and has been related to ischemic lesion location and size, and age. Direct injury to CST likely is a major contributing factor of present and subsequent motor impairment. Diffusion tensor tractography analysis allows the definition of white matter tracts, mainly the CST.

Design/Methods DESIGN/METHODS: We prospectively evaluated patients with ischemic stroke at the acute (2-7 days), subacute (30 days) and outcome (90 days) phases with DTI and upper extremity Fugl-Meyer assessment (UE-FM). The CST was reconstructed based on DTI images that were acquired in a 3T MRI unit. Virtual fiber numbers (FN) were calculated for the affected and contralateral unaffected CST at each time point. Spearman's correlation coefficients were computed for the correlation between FN ratio (affected/unaffected CST) and the UE-FM at each time point. A multivariable regression model for outcome UE-FM score prediction was also developed.

Results RESULTS: We studied 22 patients, 13 (59%) were men, age was 67(±12.5) years. Ischemic lesion location was: cortically-based hemispheric (n=16), subcortical (n=5), brainstem/cerebellum (n=1). The FN ratio significantly correlated with UE-FM scores at each time point (Acute: r=0.51, p=0.032; Subacute: r=0.56, p=0.0096; Outcome: r=0.62, p=0.0044). Baseline FN ratio significantly predicted outcome UE-FM score at outcome (p=0.008).

Conclusions CONCLUSIONS: The degree of CST involvement by ischemic stroke on DTT strongly correlates with the degree of motor impairment at each phase of ischemic stroke. The baseline FN predicts motor outcome. DTI-derived CST assessment could become a surrogate marker of motor impairment in the design of future restorative clinical trials.

Authors/Disclosures
Stefania Maraka, MD PRESENTER	Dr. Maraka has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Springworks Therapeutics. Dr. Maraka has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Alexion. Dr. Maraka has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Springworks Therapeutics. Dr. Maraka has received personal compensation in the range of $500-$4,999 for serving on a Speakers Bureau for SpringWorks Therapeutics . The institution of an immediate family member of Dr. Maraka has received research support from Baxter.
	No disclosure on file
	No disclosure on file
	No disclosure on file
	No disclosure on file
Gholam K. Motamedi, MD (Georgetown Univ Hosp/ Dept of Neuro)	Dr. Motamedi has nothing to disclose.
Shaneela Malik, MD (Henry Ford Hospital)	Dr. Malik has nothing to disclose.
	No disclosure on file
	No disclosure on file
	No disclosure on file
Panayiotis Mitsias, MD (Henry Ford Hospital, Neurology)	The institution of Dr. Mitsias has received research support from European Union.

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