Associations of Diffusion-Tensor Fractional Anisotropy and FIM Outcome Assessments After Intracerebral Hemorrhage

• Published in: Journal of stroke and cerebrovascular diseases 2018-10, Vol.27 (10), p.2869-2876
• Main Authors: Koyama, Tetsuo, Uchiyama, Yuki, Domen, Kazuhisa
• Format: Article
• Language: English
• Subjects: Activities of Daily Living; Adult; Aged; Aged, 80 and over; Anisotropy; Cerebral Hemorrhage - diagnostic imaging; Cerebral Hemorrhage - physiopathology; Cerebral Hemorrhage - psychology; Cerebral Hemorrhage - therapy; Cognition; Diffusion Tensor Imaging; Disability Evaluation; Female; Hematoma; Humans; Lower Extremity; Magnetic Resonance Imaging; Male; Middle Aged; Motor Activity; Motor Skills; Multivariate Analysis; Muscle, Skeletal - innervation; Nerve Degeneration; paresis; Patient Outcome Assessment; prediction; Predictive Value of Tests; Prognosis; Pyramidal Tracts - diagnostic imaging; Pyramidal Tracts - physiopathology; stroke; Time Factors; Upper Extremity; White Matter - diagnostic imaging; White Matter - physiopathology
• ISSN: 1052-3057; 1532-8511
• DOI: 10.1016/j.jstrokecerebrovasdis.2018.06.012

This study aimed to clarify the associations between fiber tract degeneration evaluated by diffusion-tensor imaging (DTI) and outcomes following intracerebral hemorrhage (ICH). In total, data of 40 patients from our previously published reports were assessed. Acquisition of fractional anisotropy (FA) maps was performed using DTI 14-21 days after onset; tract-based spatial statistics (TBSS) was used for the analysis. Mean FA values within the corticospinal tract (CST), the superior longitudinal fasciculus (SLF), the inferior longitudinal fasciculus, and the uncinate fasciculus were extracted from individual TBSS data. By using multivariate regression analysis, ratios of FA between lesioned and nonlesioned hemispheres were modeled to fit outcomes assessed by Brunnstrom stage (BRS) shoulder/elbow/forearm, hand/finger, and lower extremity functions and Functional Independence Measure (FIM) motor and cognition scores. Multivariate regression analyses only took the CST data into the final models for FIM-motor (adjusted R2 = .145), BRS shoulder/elbow/forearm, hand/finger, and lower extremity outcomes (adjusted R2 = .485, .503, and .425, respectively). In contrast, only the SLF data were taken into the final model for the FIM-cognition outcomes (adjusted R2 = .177). Fiber tract degeneration in the CST mainly affected motor-related outcomes such as FIM-motor and affected extremity functions assessed by using BRS, whereas that in the SLF associated with poorer cognition-related outcomes. These findings imply that, by using DTI, outcomes of patients after ICH may be predictable by assessing fiber tract degeneration in the CST and the SLF.