Correlation of Fractional Anisotropy With Motor Recovery in Patients With Stroke After Postacute Rehabilitation.
Hongmei Wen, Mohamad J Alshikho, Yao Wang and 4 others
PMID 27178097WHAT IT FOUND
In 43 stroke patients after early inpatient rehab, a brain scan measure of corticospinal tract integrity was higher in those with better motor gains.
It was linked to gains in good and moderate recovery groups, not poor recovery.
Key findings
01FA values in corticospinal tract regions were higher in good and moderate recovery clusters than in the poor recovery cluster.
02FA was linked to FIM motor gain in the good recovery cluster across the right peduncle, right CST, left CST, right PLIC, and left PLIC.
03No significant correlations were detected between FA and either ΔFIM or MRFS in the poor recovery cluster.
STILL TO COME
How it was doneWhat they foundWhat it means for PTsWhat it means for OTs
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What it does not show
Only 43 patients were analyzed, and the study was retrospective. Patients were heterogeneous: 28 had ischemic stroke, 15 had hemorrhagic stroke, and lesion location varied. Only images from one scanner and protocol were usable, which limited enrollment. The three recovery clusters were chosen subjectively after visual inspection. FA was measured at one time point, so the study cannot show how FA changes during recovery. The analysis looked only at corticospinal tract regions and did not control for demographics or other covariates. The study found associations, not effects of rehabilitation.
Declared interests
One author is reported to receive book royalty from Demos, personal fees for educational video from Oakstone, and serve on the scientific advisory board at Oxeia Biopharma. The supplied text also states Conflict of interest None and does not name a funding source.
The easy way to misread this
Do not treat fractional anisotropy as a clinical predictor of recovery. The study was small, retrospective, and found associations only, so it does not show that low FA causes poor recovery or that therapy should be changed based on the scan.