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Research ArticleBrain
Open Access

Tract-Specific and Region of Interest Analysis of Corticospinal Tract Integrity in Subcortical Ischemic Stroke: Reliability and Correlation with Motor Function of Affected Lower Extremity

P.-F. Tang, Y.-H. Ko, Z.-A. Luo, F.-C. Yeh, S.-H.A. Chen and W.-Y.I. Tseng
American Journal of Neuroradiology June 2010, 31 (6) 1023-1030; DOI: https://doi.org/10.3174/ajnr.A1981
P.-F. Tang
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Y.-H. Ko
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Z.-A. Luo
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F.-C. Yeh
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S.-H.A. Chen
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W.-Y.I. Tseng
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  • Fig 1.
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    Fig 1.

    Seed region and ROI placement on GFA maps at the (A) CP and (B) M1 in the TS analysis and at the (C) PLIC in the ROI-based analysis of bilateral CSTs corresponding to the lower extremity motor control in a patient with moderate stroke.

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    Fig 2.

    Tractography of bilateral CSTs corresponding to lower extremity motor control in a patient with ischemic stroke at the left PLIC (red area). A, The axial view of the bilateral CSTs passing through the CP; (B) the coronal view of the bilateral CSTs. For fiber direction, red indicates the left-right direction, green indicates the anteroposterior direction, and blue indicates the inferior-superior direction. The background images are GFA maps.

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    Fig 3.

    Scatterplots of the correlation between (A) the GFAPLIC-TS of the affected hemisphere and the FMA-LE motor score (r = 0.76), and (B) the GFAPLIC-ROI of the affected hemisphere and the FMA-LE motor score (r = 0.80).

Tables

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    Table 1:

    Demographics of stroke subjects

    SubjectSexAgeHandednessFootednessLesion LocationNIHSS (42)Post-Onset DaysFMA-LE Sensation (24)FMA-LE Range of Motion (22)FMA-LE Motor (34)MMSE (30)
    1M59.2RRR corona radiata78924151229
    2F66.1RRR BG, PLIC59924223428
    3M49.3RRL thalamus810224222829
    4F65.4RRR corona radiata48724223425
    5F69.0RRR corona radiata58924223426
    6M54.6RRL thalamus, PLIC79824222830
    7M50.7RRR corona radiata29124223430
    Mean59.293.624.021.029.128.1
    SD7.95.90.02.78.11.9
    • Note:—Numbers in parentheses indicate the highest possible score of the assessments.

    • View popup
    Table 2:

    Kappa values for agreement on the seed region and ROI placement in the TS and ROI-based analyses

    SubjectTS AnalysisROI-Based Analysis
    IntraraterInterrater: Raters 1 and 2IntraraterInterrater: Raters 1 and 2
    Rater 1Rater 2Rater 1Rater 2
    UHAHUHAHUHAHUHAHUHAHUHAH
    10.930.930.950.820.850.900.950.930.910.950.870.84
    20.970.970.870.820.870.900.950.950.930.990.930.93
    30.940.870.930.890.820.870.930.940.910.890.860.92
    40.920.880.790.830.810.980.950.950.840.890.890.93
    50.960.930.930.910.900.900.950.951.000.760.920.91
    60.970.940.920.920.890.860.980.940.890.820.910.90
    70.930.970.890.930.840.920.950.970.911.000.890.94
    Mean0.950.930.900.870.850.900.950.950.910.900.900.91
    SD0.020.040.050.050.030.040.010.010.050.090.030.03
    • View popup
    Table 3:

    ICC(3,1) and standard error of measurement of the GFAPLIC-TS and GFAPLIC-ROI for intra- and interrater reliability in stroke subjects

    GFAPLIC-TSGFAPLIC-ROI
    Unaffected HemisphereAffected HemisphereUnaffected HemisphereAffected Hemisphere
    ICC (95% CI)
        Intrarater reliability
            Rater 10.97* (0.83–0.99)1.00* (0.99–1.00)0.99* (0.94–1.00)1.00* (0.99–1.00)
            Rater 21.00* (1.00–1.00)0.99* (0.96–1.00)1.00* (0.97–1.00)1.00* (0.99–1.00)
        Interrater reliability
            Raters 1 and 20.85* (0.14–0.98)1.00* (0.99–1.00)1.00* (0.99–1.00)1.00* (0.99–1.00)
    Standard error of measurement
        Intrarater reliability
            Rater 10.010.010.010.01
            Rater 20.000.010.010.01
        Interrater reliability
            Raters 1 and 20.010.010.010.01
    • * P < .05 indicates significance.

    • View popup
    Table 4:

    Mean, SD, and CV of the GFA values by TS analysis and ROI-based analysis (rater 1)

    SubjectGFAPLIC-TSGFAPLIC-ROI
    Unaffected HemisphereAffected HemisphereUnaffected HemisphereAffected Hemisphere
    MeanSDCVMeanSDCVMeanSDCVMeanSDCV
    10.430.030.070.200.040.210.410.070.170.180.080.44
    20.440.040.090.330.050.160.400.080.200.240.130.54
    30.420.020.050.340.070.220.370.070.190.290.100.34
    40.400.050.130.380.020.060.330.090.270.300.080.27
    50.410.030.070.430.030.070.360.090.250.320.100.31
    60.450.030.070.220.080.360.340.100.290.240.100.42
    70.460.030.070.320.030.100.310.080.260.280.080.29
    Group mean0.43*0.03*0.08*0.32*0.05*0.17*0.360.080.230.260.100.37
    Group SD0.020.010.030.080.020.100.040.010.050.050.020.10
    • * P < .05 indicates significant differences between the TS- and ROI-based analyses.

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American Journal of Neuroradiology: 31 (6)
American Journal of Neuroradiology
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1 Jun 2010
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Tract-Specific and Region of Interest Analysis of Corticospinal Tract Integrity in Subcortical Ischemic Stroke: Reliability and Correlation with Motor Function of Affected Lower Extremity
P.-F. Tang, Y.-H. Ko, Z.-A. Luo, F.-C. Yeh, S.-H.A. Chen, W.-Y.I. Tseng
American Journal of Neuroradiology Jun 2010, 31 (6) 1023-1030; DOI: 10.3174/ajnr.A1981
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P.-F. Tang, Y.-H. Ko, Z.-A. Luo, F.-C. Yeh, S.-H.A. Chen, W.-Y.I. Tseng
Tract-Specific and Region of Interest Analysis of Corticospinal Tract Integrity in Subcortical Ischemic Stroke: Reliability and Correlation with Motor Function of Affected Lower Extremity
American Journal of Neuroradiology Jun 2010, 31 (6) 1023-1030; DOI: 10.3174/ajnr.A1981

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