Applicability of fractional anisotropy from standardized automated tractography for outcome prediction of patients after stroke.
Tetsuo Koyama, Midori Mochizuki, Yuki Uchiyama and 1 others
PMID 38075519WHAT IT FOUND
In 14 stroke patients, fractional anisotropy from automated tractography strongly predicted long-term motor recovery.
This method worked even when comparing raw lesion-side scores, unlike standard region-of-interest mapping which failed on raw scores. It offers a practical tool for prognosis without needing healthy-side comparisons.
Key findings
01Raw fractional anisotropy values from automated tractography of the corticospinal tract on the lesion side correlated strongly with long-term motor function (r=0.813, p<0.001).
02Raw fractional anisotropy values from standard region-of-interest mapping on the lesion side did not correlate significantly with motor function (r=0.507, p=0.064).
03The ratio of fractional anisotropy between lesion and non-lesion sides correlated strongly with motor function for both methods (ROI: r=0.846; tractography: r=0.849).
STILL TO COME
How it was doneWhat they foundWhat it means for PTsWhat it means for OTsWhat it means for SLPs
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What it does not show
The sample size was very small (14 patients), limiting the generalizability of the findings. The study only included patients with hemorrhagic strokes in the thalamus or putamen, so it is unclear if these results apply to ischemic strokes or other lesion locations. Patients were selected only if they were functionally independent before stroke and did not have subsequent neurological deterioration, which excludes many complex cases. The study was retrospective, relying on existing medical records rather than a controlled experimental design.
Declared interests
The authors declare no conflicts of interest. The work was supported by grants from the Japan Society for the Promotion of Science.
The easy way to misread this
Do not assume this imaging method is ready for routine clinical use. The finding relies on a tiny sample of 14 patients with specific hemorrhagic strokes, and the 'automated tractography' requires significant computational power that may not be available in all clinics.