Annals of Rehabilitation Medicine

"Neuroimaging"

Original Articles

Brain disorders

Associations Between Stroke Outcome Assessments and Automated Tractography Fractional Anisotropy Incorporating Age: Midori Mochizuki, Yuki Uchiyama, Kazuhisa Domen, Tetsuo Koyama; Ann Rehabil Med 2025;49(1):15-22. Published online February 13, 2025; DOI: https://doi.org/10.5535/arm.240073

Abstract
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Objective
To evaluate the association between outcomes, including affected extremity functions and activities of daily living (ADL), and fractional anisotropy (FA) derived from automated tractography incorporating age among patients after stroke.
Methods
This study enrolled stroke patients, and diffusion-tensor imaging was conducted during the second week. Standardized automated tractography was utilized to compute FA values in the corticospinal tract (CST), the inferior fronto-occipital fasciculus (IFOF), and the superior longitudinal fasciculus (SLF). Outcome evaluations were performed at discharge from our affiliated rehabilitation facility. Extremity functions were assessed using the total scores of the motor component of the Stroke Impairment Assessment Set (SIAS-motor). Independence levels in ADL were appraised through the motor and cognition components of the Functional Independence Measure (FIM). For each outcome measure, multivariate regression analysis incorporated the FA values of the CST, the IFOF, and the SLF, along with age.
Results
Forty-two patients were enrolled in the final analytical database. Among the four explanatory variables, the CST emerged as the most influential factor for SIAS-motor scores. Conversely, age proved to be the primary determinant for both the motor and cognition components of FIM, surpassing the impact of FA metrics, including the CST and the IFOF.
Conclusion
The key influencing factors exhibited significant variations based on the targeted outcome assessments. Clinicians should be aware of these differences when utilizing neuroimaging techniques to predict stroke outcomes.

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Lesion Characteristics of Chronic Dysphagia in Patients With Supratentorial Stroke: Sol Jang, Hea Eun Yang, Hee Seung Yang, Dae Hyun Kim; Ann Rehabil Med 2017;41(2):225-230. Published online April 27, 2017; DOI: https://doi.org/10.5535/arm.2017.41.2.225

Abstract
PDF

Objective

To analyze the relationship between brain lesion location and type of chronic dysphagia in patients with supratentorial stroke.

Methods

Data from 82 chronic stroke patients who underwent videofluoroscopic swallowing studies at >6 months after an initial stroke event were retrospectively analyzed. Delayed oral transit time, delayed pharyngeal transit time, and the presence of aspiration were extracted. A voxel-based lesion symptom mapping (VLSM) analysis was used to correlate types of dysphagia with specific brain lesions.

Results

VLSM identified several clusters of voxels that significantly correlated with type of dysphagia. Delayed oral transit time mainly correlated with lesions in the left inferior frontal lobe and precentral gyrus; delayed pharyngeal time mainly correlated with lesions in the right basal ganglia and corona radiate; and aspiration was mainly correlated with lesions in the putamen.

Conclusion

Understanding the association between lesion location and dysphagia in chronic stroke patients is an important first step towards predicting permanent dysphagia after stroke. Improved understanding of the neural correlates of dysphagia will inform the utility of interventions for its treatment and prevention after stroke.

Citations

Citations to this article as recorded by

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