Article

Initial evidence suggests that the integrity of the ipsilesional
corticospinal tract (CST) after stroke is strongly related to motor function in
the chronic state but not the treatment gain induced by motor rehabilitation.
OBJECTIVE: We examined the association of motor status and treatment benefit by
testing patients with a wide range of severity of hemiparesis of the left and
right upper extremity. METHOD: Diffusion tensor imaging was performed in 22
patients beyond 12 months after onset of stroke with severe to moderate
hemiparesis. Motor function was tested before and after 2 weeks of modified
constraint-induced movement therapy. RESULTS: CST integrity, but not lesion
volume, correlated with the motor ability measures of the Wolf Motor Function
Test and the Motor Activity Log. No differences were found between left and right
hemiparesis. Motor performance improved significantly with the treatment regime,
and did so equally for patients with left and right arm paresis. However,
treatment benefit was not associated with either CST integrity or lesion volume.
CONCLUSION: CST integrity correlated best in this small trial with chronic
long-term status but not treatment-induced improvements. The CST may play a
different role in the mechanisms mediating long-term outcome compared to those
underlying practice-induced gains after a chronic plateau in motor function.

Langue : ANGLAIS