An overview of fractional anisotropy as a reliable quantitative measurement for the corticospinal tract (CST) integrity in correlation with a Fugl-Meyer assessment in stroke rehabilitation.
Mohd Khairul Izamil Zolkefley, Younis M S Firwana, Hasnettty Zuria Mohamed Hatta and 5 others
PMID 33519079WHAT IT FOUND
Fractional anisotropy (FA) from MRI correlates with Fugl-Meyer motor scores in chronic stroke, but the relationship is inconsistent across studies.
Ipsilesional FA tracks recovery better than contralesional FA. Use these imaging markers to inform prognosis, not as standalone diagnostic tools.
Key findings
01The relationship between FA and FMA scores was significant in only half of the reviewed studies for ipsilesional CST, with inconsistent findings for other FA variables.
02Ipsilesional FA metrics can predict rehabilitation response, whereas contralesional FA correlates with impairment but does not predict functional recovery potential.
03The significance of FA as a biomarker varies by region of interest, with strong correlations found in the internal capsule but not in the pontine CST.
STILL TO COME
How it was doneWhat they foundWhat it means for PTsWhat it means for OTs
Read the rest of this summary
You get three full summaries a month, free, and we do not ask for a card. Search, the TL;DRs and your library stay unlimited either way.
What it does not show
This is a narrative review, not a systematic review or meta-analysis, so the selection of studies and synthesis may be biased. The correlation between FA and FMA was significant in less than half of the included studies for ipsilesional CST, indicating inconsistent evidence. Many included studies had small sample sizes and heterogeneous patient populations, affecting generalizability. The review includes animal studies and human data, which may not directly translate to clinical practice.
Declared interests
Funded by the Newton Ungku Omar Fund and MIGHT grant. The authors declared no conflicts of interest.
The easy way to misread this
Do not assume that a single FA measurement can reliably predict a patient's motor recovery. The review found significant correlations in only 48.1% of studies for ipsilesional CST, and contralesional FA did not predict functional potential.