Recovery of a partially damaged corticospinal tract in a patient with intracerebral hemorrhage: A diffusion tensor image study

Article type: Research Article

Authors: Jang, Sung Ho | Byun, Woo Mok | Han, Bong Soo | Park, Hae-Jeong | Bai, Daiseg | Ahn, Young Hwan | Kwon, Yong-Hyun | Lee, Mi Young

Affiliations: Department of Physical Medicine and Rehabilitation, School of Medicine, Yeungnam University 317-1, Daemyungdong, Namku, Taegu, 705-717, Republic of Korea | Department of Diagnostic Radiology, School of Medicine, Yeungnam University 317-1, Daemyungdong, Namku, Taegu, 705-717, Republic of Korea | Department of Radiation Science, Yonsei University College of Health Science, Wonju-si, Kangwon-do, 220-710, Republic of Korea | Department of Diagnostic Radiology, Yonsei University College of Medicine 134 Shinchon-dong, Seodaemun-gu, Seoul 120-749, Korea | Division of Clinical Psychology, Department of Psychiatry, School of Medicine, Yeungnam University 317-1, Daemyungdong, Namku, Taegu, 705-717, Republic of Korea | Department of Neurosurgery, School of Medicine, Ajou University, Suwon, 443-721, Republic of Korea | Department of Rehabilitation Science, Daegu University 2288, Daemyungdong, Namku, Taegu, 705-030, Republic of Korea

Note: [] Corresponding author. Tel.: +82 53 620 3269; Fax: +82 53 620 3269; E-mail: strokerehab@hanmail.net

Abstract: Purpose: We hypothesized that diffusion tensor imaging (DTI) could be useful for exploring corticospinal tract (CST) regeneration if longitudinal changes of diffusion anisotropy can be detected. In this study, we explored the recovery of a CST partially damaged by intracerebral hematoma in a patient by DTI. Methods: A 61-year-old female patient and six age-matched control subjects were evaluated. The patient presented with complete paralysis of the left extremities, which occurred at the onset of a spontaneous intracerebral hemorrhage (ICH) in the right corona radiata and internal capsule. Over the five-month period following onset, motor function of the affected extremities slowly recovered to the normal range. Two longitudinal DTIs were acquired from the patient (at 3 weeks and 5 months from onset) and one DTI from the control subjects. Fractional anisotropy (FA) and apparent diffusion coefficient (ADC) were measured using a region of interest (ROI) method. Results: On the 3-week DTI, FA values of ROIs in the ICH regions in the affected hemisphere were significantly lower, and ADC values of ROIs in the same areas were significantly higher than those of the control subjects (p<0.002). However, both mean FA and ADC values of the affected hemisphere in the 5-month DTI showed no significant differences versus those of the control.

Journal: Restorative Neurology and Neuroscience, vol. 24, no. 1, pp. 25-29, 2006