Prediction of muscle loss after stroke by analysis of corticospinal tract

Introduction Skeletal muscle loss induces a poor rehabilitation outcome after stroke. Little is known about the usefulness of diffusion tensor tractography (DTT) findings of the corticospinal tract (CST) in terms of predicting muscle loss in affected limbs after stroke. Methods This research was designed as a preliminary study. Forty-four patients, with stroke onset more than one year earlier, were recruited. DTT was performed within 7-30 days after stroke onset. The patients were classified into two groups based on the DTT findings: a DTT+ group, in which the CST was preserved, and a DTT- group, in which the CST was interrupted by the stroke lesion. Additionally, the patients' functions were evaluated based on the modified Brunnstrom classification and functional ambulation category. Results In the DTT- group, the values of the lean tissue mass of the affected upper and lower limbs were smaller than those of the unaffected side. On the other hand, in the DTT+ group, the values of the lean tissue mass between the affected and unaffected limbs were not significantly different. Conclusion The DTT evaluation of CST at the early stage of stroke may be useful for predicting muscle loss of the affected limb at the chronic stage in stroke patients.