Article

Clarification of the clinical characteristics of motor function in stroke
patients with complete corticospinal tract (CST) injury would be of importance in
stroke rehabilitation. However, this topic has not been clearly elucidated. We
conducted an investigation of the clinical characteristics of motor function in
chronic hemiparetic stroke patients with complete CST injury, as confirmed by
transcranial magnetic stimulation and diffusion tensor imaging. Forty-one
consecutive chronic hemiparetic stroke patients who showed an absence of motor
evoked potential in muscles of the upper and lower extremities upon transcranial
magnetic stimulation and in whom the integrity of the CST discontinued around
stroke lesion on diffusion tensor imaging tractography were recruited. Mean
Medical Research Council scores for distal musculature were lower than those for
proximal musculature (P< 0.001). Mean Medical Research Council scores for upper
extremity muscles were lower than those for lower extremity muscles (P< 0.001).
The mean Motricity Index score for muscles of the upper extremities was lower
than that for muscles of the lower extremities (P< 0.001). None of the patients
had a functional hand; in contrast, 56% of patients were able to walk
independently. We found that motor weaknesses of distal joint musculature and
upper extremities were more severe than those of proximal joint musculature and
lower extremities following complete injury of the CST in stroke, respectively.
As a result, despite the absence of a functional hand in all patients, more than
half were able to walk independently.

Langue : ANGLAIS