Combining diffusion tensor imaging with motor evoked potentials in the evaluation of upper limb motor function post-stroke
10.3760/cma.j.cn421666-20220605-00608
- VernacularTitle:弥散张量成像联合运动诱发电位在脑卒中患者上肢运动功能评估中的应用研究
- Author:
Ying LI
1
;
Yaxin YANG
;
Haifeng YUAN
;
Ben MA
;
Zhongheng WU
;
Jing FU
;
Qiaojun ZHANG
Author Information
1. 西安交通大学第二附属医院康复医学科，西安 710000
- Publication Type:Journal Article
- Keywords:
Diffusion tensor imaging;
Motor evoked potentials;
Stroke;
Upper limb motor function;
Prognosis
- From:
Chinese Journal of Physical Medicine and Rehabilitation
2025;47(1):13-18
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To observe effectiveness of combining diffusion tensor imaging (DTI) with motor evoked potentials (MEPs) in evaluating the upper limb motor functioning of stroke survivors.Methods:Thirty-seven stroke survivors with upper limb motor dysfunction were selected. At the 4th, 12th and 24th week after their onset, each was were assessed using Fugl-Meyer Upper Limb (FMA-UE) scoring, the National Institutes of Health stroke scale (NIHSS), the modified Rankin Scale (mRS), the Barthel Index (BI) and hemiplegic hand function classification. DTI was also applied and MEPs were measured. The patients were divided into an MEP positive group and an MEP negative group according to the existence of the MEP waveform. The DTI and MEP parameters were correlated with the FMA-UE scores, linear regressions were evaluated and a receiver operating characteristics curve was prepared to estimate the utility of DTI in predicting hand function. The sensitivity and specificity of MEPs in predicting hand function recovery were evaluated.Results:The asymmetry index (FAa) of the average anisotropy score of the posterior limb of the internal capsule and the FAa of the cerebral peduncle were both significantly correlated with the FMA-UE scores at the 12th and 24th weeks. The best cut-off points for predicting functional recovery of a patient′s hand were 0.155 for the FAa of the posterior limb of the internal capsule and 0.145 for the cerebral peduncle. Among the 37 patients, the MEPs of 8 (the MEP positive group) could be extracted, and their hand functions recovered completely. The sensitivity of the MEPs in predicting the complete recovery of hand function was 80% with 100% specificity. The linear regression analysis showed 77% prediction accuracy for the FAa and MEPs of the cerebral peduncle for upper limb motor function at the 24th week after onset. In the MEP negative group, two patients completely recovered their hand function, with one′s FAa less than 0.145, and the other′s more than 0.145. When the MEP was negative, the sensitivity of DTI in predicting the recovery of hand function was 50% with 81.5% specificity.Conclusions:DTI combined with MEPs can be used as an index to evaluate the prognosis of upper limb motor function in stroke patients.
