TY - JOUR
T1 - White matter integrity of contralesional and transcallosal tracts may predict response to upper limb task-specific training in chronic stroke
AU - Mattos, Daniela J.S.
AU - Rutlin, Jerrel
AU - Hong, Xin
AU - Zinn, Kristina
AU - Shimony, Joshua S.
AU - Carter, Alexandre R.
N1 - Publisher Copyright:
© 2021
PY - 2021/1
Y1 - 2021/1
N2 - Objective: To investigate white matter (WM) plasticity induced by intensive upper limb (UL) task specific training (TST) in chronic stroke. Methods: Diffusion tensor imaging data and UL function measured by the Action Research Arm Test (ARAT) were collected in 30 individuals with chronic stroke prior to and after intensive TST. ANOVAs tested the effects of training on the entire sample and on the Responders [ΔARAT ≥ 5.8, N = 13] and Non-Responders [ΔARAT < 5.8, N = 17] groups. Baseline fractional anisotropy (FA) values were correlated with ARATpost TST controlling for baseline ARAT and age to identify voxels predictive of response to TST. Results. While ARAT scores increased following training (p < 0.0001), FA changes within major WM tracts were not significant at p < 0.05. In the Responder group, larger baseline FA of both contralesional (CL) and transcallosal tracts predicted larger ARAT scores post-TST. Subcortical lesions and more severe damage to transcallosal tracts were more pronounced in the Non-Responder than in the Responder group. Conclusions: The motor improvements post-TST in the Responder group may reflect the engagement of interhemispheric processes not available to the Non-Responder group. Future studies should clarify differences in the role of CL and transcallosal pathways as biomarkers of recovery in response to training for individuals with cortical and subcortical stroke. This knowledge may help to identify sources of heterogeneity in stroke recovery, which is necessary for the development of customized rehabilitation interventions.
AB - Objective: To investigate white matter (WM) plasticity induced by intensive upper limb (UL) task specific training (TST) in chronic stroke. Methods: Diffusion tensor imaging data and UL function measured by the Action Research Arm Test (ARAT) were collected in 30 individuals with chronic stroke prior to and after intensive TST. ANOVAs tested the effects of training on the entire sample and on the Responders [ΔARAT ≥ 5.8, N = 13] and Non-Responders [ΔARAT < 5.8, N = 17] groups. Baseline fractional anisotropy (FA) values were correlated with ARATpost TST controlling for baseline ARAT and age to identify voxels predictive of response to TST. Results. While ARAT scores increased following training (p < 0.0001), FA changes within major WM tracts were not significant at p < 0.05. In the Responder group, larger baseline FA of both contralesional (CL) and transcallosal tracts predicted larger ARAT scores post-TST. Subcortical lesions and more severe damage to transcallosal tracts were more pronounced in the Non-Responder than in the Responder group. Conclusions: The motor improvements post-TST in the Responder group may reflect the engagement of interhemispheric processes not available to the Non-Responder group. Future studies should clarify differences in the role of CL and transcallosal pathways as biomarkers of recovery in response to training for individuals with cortical and subcortical stroke. This knowledge may help to identify sources of heterogeneity in stroke recovery, which is necessary for the development of customized rehabilitation interventions.
KW - Diffusion tensor imaging
KW - Neuroimaging biomarker
KW - Stroke rehabilitation
KW - Task specific training
KW - Transcallosal fibers
KW - Upper limb
UR - http://www.scopus.com/inward/record.url?scp=85108165596&partnerID=8YFLogxK
U2 - 10.1016/j.nicl.2021.102710
DO - 10.1016/j.nicl.2021.102710
M3 - Article
C2 - 34126348
AN - SCOPUS:85108165596
SN - 2213-1582
VL - 31
JO - NeuroImage: Clinical
JF - NeuroImage: Clinical
M1 - 102710
ER -