Early brain imaging predictors of post-stroke spasticity.
Songjin Ri, Stefanie Glaess-Leistner, Jörg Wissel
PMID 33616193WHAT IT FOUND
Patients with first ischaemic stroke who developed spasticity within 3 months more often had early MRI lesions larger than 3 cm3 in motor-network areas.
Small cortical lesions were rarely associated with spasticity.
Key findings
01Patients with spasticity had larger total stroke lesion volumes than patients without spasticity.
02Lesions involving motor-network structures were larger in patients with spasticity.
03A motor-network lesion volume larger than 3 cm3 was found in 14 patients with spasticity and 6 patients without spasticity.
STILL TO COME
How it was doneWhat they foundWhat it means for PTs
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What it does not show
Only 23 patients developed spasticity, so the study may not capture all patterns in larger populations. Follow-up stopped at 3 months, so it does not show whether spasticity appeared later or whether imaging findings predicted long-term tone. Patients with aphasia were excluded, so the findings do not apply to that group. The study did not test whether using these MRI cut-offs to guide care changes patient outcomes. It is an observational study, so it shows association, not that lesion volume caused spasticity.
The easy way to misread this
Do not use these MRI cut-offs as a diagnosis or as proof that a patient will develop spasticity. The study found associations at 3 months, and many patients without spasticity also had large lesions.