Relationship of Recovery of Contralesional Ankle Weakness With the Corticospinal and Corticoreticular Tracts in Stroke Patients.
Sung Ho Jang, Min Kyeong Cho
PMID 35706118WHAT IT FOUND
In stroke patients with severe initial ankle weakness, good recovery was strongly linked to a higher number of nerve fibers in the contralesional corticoreticular tract.
This suggests the undamaged side's reticular pathway supports ankle function when the primary motor pathway is completely injured.
Key findings
01Patients with good ankle recovery had significantly higher tract volumes in the contralesional corticoreticular tract compared to those with poor recovery.
02The volume of the contralesional corticoreticular tract showed a strong positive correlation with ankle dorsiflexion strength scores.
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 study was retrospective, so it could not track changes in brain connectivity from the acute phase to the chronic phase. Diffusion tensor imaging can produce false-negative results, meaning some fiber tracts thought to be completely injured might have had small, undetected connections. The study did not control for or detail the specific intensity or types of rehabilitation each patient received, which could influence recovery. The sample size was small (36 patients), limiting the generalizability of the findings. The patients had complete injuries to the ipsilesional tracts, so these results do not apply to the majority of stroke patients with partial injuries.
Declared interests
The authors declared no conflicts of interest. The study was supported by non-US government funding.
The easy way to misread this
Do not assume that targeting the contralesional corticoreticular tract will improve recovery in all stroke patients. This link was only found in patients with complete injury to the ipsilesional corticospinal tract, and the study shows association, not that stimulating this area causes recovery.