Significance of Corticospinal, Associative and Inter-Hemispheric Tracts for the Development of Posttraumatic Hemiparesis
Motor disorders are among the most common consequences of severe craniocerebral injury (traumatic brain injury — TBI). Deeper insights into pathophysiological mechanisms of these disorders is important both from a theoretical point of view and in terms of improving neurorehabilitation approaches.The...
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Federal Research and Clinical Center of Intensive Care Medicine and Rehabilitology, Moscow, Russia
2023-12-01
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| Series: | Общая реаниматология |
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| Online Access: | https://www.reanimatology.com/rmt/article/view/2407 |
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| author | E. L. Pogosbekian E. V. Sharova L. M. Fadeeva M. V. Shtern E. V. Aleksandrova N. E. Zakharova I. N. Pronin |
| author_facet | E. L. Pogosbekian E. V. Sharova L. M. Fadeeva M. V. Shtern E. V. Aleksandrova N. E. Zakharova I. N. Pronin |
| author_sort | E. L. Pogosbekian |
| collection | DOAJ |
| description | Motor disorders are among the most common consequences of severe craniocerebral injury (traumatic brain injury — TBI). Deeper insights into pathophysiological mechanisms of these disorders is important both from a theoretical point of view and in terms of improving neurorehabilitation approaches.The aim of the study was to investigate the correlation of right–sided posttraumatic hemiparesis severity with composite characteristics of fractional anisotropy (FA) in the segments of the corpus callosum (CC), corticospinal tract (CST) and the inferior fronto-occipital fasciculus (IFO) at different stages of traumatic disease (acute, subacute and long-term periods).Material and methods. Cases of 43 patients with TBI were analyzed (28 men and 15 women aged 13 to 59 years, mean age 28±9 years). Forty patients were diagnosed with severe TBI with diffuse axonal damage, three patients had moderate severity TBI. Long-term follow up included continuous clinical and neurological examination with evaluation of patient’s level of consciousness using the CRS-R scale, and the degree of motor deficits in right-sided hemiparesis using a five-point scale. During three post-TBI periods (up to 1 month, from 1 to 6 months, and from 6 to 12 months), patients were examined using diffusion tensor MRI (DTI), tractography and FA. Motor, cortico-spinal tracts and IFO were divided by measurement grid, correlations between FA and scores of right-sided hemiparesis were calculated for each segment.Results. FA correlations (P0.05) with the severity of hemiparesis were established not only for CST motor-specific segments, but also for some CC and IFO segments. In the early period of TBI significant correlations with hemiparesis severity were found not only in the contralateral CST segments, but also in the ipsilateral ones. Significant differences in FA in the related CC and CST segments were found between the groups with good and limited motor recovery: at all stages after TBI, FA was higher in patients with successful recovery.Conclusion. The results of the study provide better insight into pathophysiological mechanisms of post-traumatic motor disorders development, therefore favoring optimization of therapeutic strategies. |
| format | Article |
| id | doaj-art-d75227f178ec4b589ea29b29d02b3a4c |
| institution | Kabale University |
| issn | 1813-9779 2411-7110 |
| language | English |
| publishDate | 2023-12-01 |
| publisher | Federal Research and Clinical Center of Intensive Care Medicine and Rehabilitology, Moscow, Russia |
| record_format | Article |
| series | Общая реаниматология |
| spelling | doaj-art-d75227f178ec4b589ea29b29d02b3a4c2025-08-20T03:35:08ZengFederal Research and Clinical Center of Intensive Care Medicine and Rehabilitology, Moscow, RussiaОбщая реаниматология1813-97792411-71102023-12-01196253810.15360/1813-9779-2023-6-25-381932Significance of Corticospinal, Associative and Inter-Hemispheric Tracts for the Development of Posttraumatic HemiparesisE. L. Pogosbekian0E. V. Sharova1L. M. Fadeeva2M. V. Shtern3E. V. Aleksandrova4N. E. Zakharova5I. N. Pronin6Institute of Higher Nervous Activity and Neurophysiology, RAS; N. N. Burdenko National Medical Research Center of Neurosurgery, Ministry of Health of RussiaInstitute of Higher Nervous Activity and Neurophysiology, RASN. N. Burdenko National Medical Research Center of Neurosurgery, Ministry of Health of RussiaFederal Research and Clinical Center of Intensive Care Medicine and RehabilitologyN. N. Burdenko National Medical Research Center of Neurosurgery, Ministry of Health of RussiaN. N. Burdenko National Medical Research Center of Neurosurgery, Ministry of Health of RussiaN. N. Burdenko National Medical Research Center of Neurosurgery, Ministry of Health of RussiaMotor disorders are among the most common consequences of severe craniocerebral injury (traumatic brain injury — TBI). Deeper insights into pathophysiological mechanisms of these disorders is important both from a theoretical point of view and in terms of improving neurorehabilitation approaches.The aim of the study was to investigate the correlation of right–sided posttraumatic hemiparesis severity with composite characteristics of fractional anisotropy (FA) in the segments of the corpus callosum (CC), corticospinal tract (CST) and the inferior fronto-occipital fasciculus (IFO) at different stages of traumatic disease (acute, subacute and long-term periods).Material and methods. Cases of 43 patients with TBI were analyzed (28 men and 15 women aged 13 to 59 years, mean age 28±9 years). Forty patients were diagnosed with severe TBI with diffuse axonal damage, three patients had moderate severity TBI. Long-term follow up included continuous clinical and neurological examination with evaluation of patient’s level of consciousness using the CRS-R scale, and the degree of motor deficits in right-sided hemiparesis using a five-point scale. During three post-TBI periods (up to 1 month, from 1 to 6 months, and from 6 to 12 months), patients were examined using diffusion tensor MRI (DTI), tractography and FA. Motor, cortico-spinal tracts and IFO were divided by measurement grid, correlations between FA and scores of right-sided hemiparesis were calculated for each segment.Results. FA correlations (P0.05) with the severity of hemiparesis were established not only for CST motor-specific segments, but also for some CC and IFO segments. In the early period of TBI significant correlations with hemiparesis severity were found not only in the contralateral CST segments, but also in the ipsilateral ones. Significant differences in FA in the related CC and CST segments were found between the groups with good and limited motor recovery: at all stages after TBI, FA was higher in patients with successful recovery.Conclusion. The results of the study provide better insight into pathophysiological mechanisms of post-traumatic motor disorders development, therefore favoring optimization of therapeutic strategies.https://www.reanimatology.com/rmt/article/view/2407tbitractographyhemiparesisfractional anisotropy |
| spellingShingle | E. L. Pogosbekian E. V. Sharova L. M. Fadeeva M. V. Shtern E. V. Aleksandrova N. E. Zakharova I. N. Pronin Significance of Corticospinal, Associative and Inter-Hemispheric Tracts for the Development of Posttraumatic Hemiparesis Общая реаниматология tbi tractography hemiparesis fractional anisotropy |
| title | Significance of Corticospinal, Associative and Inter-Hemispheric Tracts for the Development of Posttraumatic Hemiparesis |
| title_full | Significance of Corticospinal, Associative and Inter-Hemispheric Tracts for the Development of Posttraumatic Hemiparesis |
| title_fullStr | Significance of Corticospinal, Associative and Inter-Hemispheric Tracts for the Development of Posttraumatic Hemiparesis |
| title_full_unstemmed | Significance of Corticospinal, Associative and Inter-Hemispheric Tracts for the Development of Posttraumatic Hemiparesis |
| title_short | Significance of Corticospinal, Associative and Inter-Hemispheric Tracts for the Development of Posttraumatic Hemiparesis |
| title_sort | significance of corticospinal associative and inter hemispheric tracts for the development of posttraumatic hemiparesis |
| topic | tbi tractography hemiparesis fractional anisotropy |
| url | https://www.reanimatology.com/rmt/article/view/2407 |
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