Abstract 87: Neuroimaging, Not Clinical Assessment Predicts Post-Stroke Motor Outcome in Severely Impaired Stroke Patients
Background: Initial motor impairment by clinical assessment and neuroimaging measures of corticospinal tract injury have been shown to predict 3-month motor outcome in mild-to-moderately impaired stroke patients. Clinical assessment alone is good to predict outcome of more severely impaired patients. This study aims to compare clinical assessment with neuroimaging in severely impaired patients.
Methods: This study followed 27 first-ever ischemic stroke patients who presented with severe motor impairment at baseline( between 2- 5 days after stroke) which is defined as Upper Extremity Fugl-Meyer (UE-FM) Scale was <=5. Patients will be assessed at 3 months (90 ±14 days) again with UE_FM. A weighted CST lesion load (wCST-LL) was calculated by overlaying each patient’s lesion map on MRI with a probabilistic CST constructed from healthy subjects. A regression analysis was applied to assess the predictive value of wCST-LL and initial motor impairment.
Results: Initial motor impairment has no predictive value (p=0.25, R2=0.05) while wCST-LL has a strong prediction (p=0.002, R2=0.31) for post-stroke motor outcome in this severely impaired stroke group. If wCST is more than 7 cc, no patient recovers more than 20 on UE_FM at 3 months.
Conclusion: Compared with clinical assessment, a neuroimaging measure of CST injury excels in post-stroke motor outcome prediction in a severely impaired subgroup.
- © 2012 by American Heart Association, Inc.