Background: Severity of arm impairment alone does not explain motor outcomes in people with severe impairment post stroke.
Objective: Define the contribution of brain biomarkers to upper limb motor outcomes in people with severe arm impairment post stroke.
Methods: Paretic arm impairment (Fugl-Meyer upper limb, FM-UL) and function (Wolf Motor Function Test rate, WMFT-rate) were measured in 15 individuals with severe (FM-UL ≤ 30/66) and 14 with mild-moderate (FM-UL > 40/66) impairment. Transcranial magnetic stimulation and diffusion weight imaging indexed structure and function of the corticospinal tract and corpus callosum. Separate models of the relationship between possible biomarkers and motor outcomes at a single chronic (≥6 months) time point post stroke were performed.
Results: Age (Δ0.365, = 0.017) and ipsilesional-transcallosal inhibition (Δ0.182, = 0.048) explained a 54.7% ( = 0.009) variance in paretic WMFT-rate. Prefrontal corpus callous fractional anisotropy (PF-CC FA) alone explained 49.3% ( = 0.007) variance in FM-UL outcome. The same models did not explain significant variance in mild-moderate stroke. In the severe group, k-means cluster analysis of PF-CC FA distinguished two subgroups, separated by a clinically meaningful and significant difference in motor impairment ( = 0.049) and function ( = 0.006) outcomes.
Conclusion: Corpus callosum function and structure were identified as possible biomarkers of motor outcome in people with chronic and severe arm impairment.
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| http://dx.doi.org/10.1155/2017/4281532 | DOI Listing |
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