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The following is a summary of “Association Between Changes in White Matter Volume Detected With Diffusion Tensor–Based Morphometry and Motor Recovery After Stroke,” published in the March 2025 issue of Neurology by Edwardson et al.
Diffusion tensor–based morphometry (DTBM) accurately assesses white matter volume changes, detecting CST loss and its link to stroke recovery.
Researchers conducted a retrospective study on DTBM’s ability to detect corticospinal tract (CST) volume loss and its link to stroke recovery.
They analyzed retrospective MRI scans from participants with acute anterior circulation ischemic stroke and (NIH Stroke Scale [NIHSS] arm score ≥2. They computed delta FA and LnJ maps from scans taken <36 hours and 30 days post-stroke. They used voxel-wise Spearman analysis to identify regions of interest (ROIs) where delta FA and LnJ correlated with NIHSS arm recovery. They compared delta FA and LnJ maps between good (delta NIHSS ≥2) and poor (delta NIHSS <2) recovery groups using controls.
The results showed that 21 participants (mean age 63.6 years, 48% female, median NIHSS arm score 4) were evaluated. Voxel-wise maps identified 2 delta FA ROIs and 4 LnJ ROIs strongly correlated with arm motor recovery (Spearman ρ = 0.77–0.81, all P < 0.01). Delta FA ROIs included the corona radiata and adjacent white matter, while LnJ ROIs included the centrum semiovale, corona radiata, internal capsule, and pons. Poor recovery groups showed diffuse CST changes in delta FA maps, while LnJ maps showed focal CST changes in the brainstem and internal capsule.
Investigators found that DTBM detected focal CST volume loss over 30 days, likely due to Wallerian degeneration. These changes correlated with arm motor recovery and complemented FA in assessing white matter loss after stroke.
Source: neurology.org/doi/10.1212/WNL.0000000000213408
