Corticospinal Tract Lesion Load Originating From Both Ventral Premotor and Primary Motor Cortices Are Associated With Post-stroke Motor Severity

  • Kaori L. Ito
    Division of Occupational Science and Occupational Therapy, Herman Ostrow School of Dentistry, University of Southern California, Los Angeles, CA, USA
  • Bokkyu Kim
    Department of Physical Therapy Education, College of Health Professions, SUNY Upstate Medical University, Syracuse, NY, USA
  • Jingchun Liu
    Department of Radiology and Tianjin Key Laboratory of Functional Imaging, Tianjin Medical University General Hospital, Tianjin, China
  • Surjo R. Soekadar
    Clinical Neurotechnology Laboratory, Dept. of Psychiatry and Neurosciences (CCM), Charité – Universitätsmedizin Berlin, Berlin, Germany
  • Carolee Winstein
    Division of Biokinesiology and Physical Therapy, Herman Ostrow School of Dentistry, University of Southern California, Los Angeles, CA, USA
  • Chunshui Yu
    Department of Radiology and Tianjin Key Laboratory of Functional Imaging, Tianjin Medical University General Hospital, Tianjin, China
  • Steven C. Cramer
    Department of Neurology, UCLA; California Rehabilitation Institute, Los Angeles, CA, USA
  • Nicolas Schweighofer
    Division of Biokinesiology and Physical Therapy, Herman Ostrow School of Dentistry, University of Southern California, Los Angeles, CA, USA
  • Sook-Lei Liew
    Division of Occupational Science and Occupational Therapy, Herman Ostrow School of Dentistry, University of Southern California, Los Angeles, CA, USA

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<jats:p> Lesion load of the corticospinal tract (CST-LL), a measure of overlap between a stroke lesion and the CST, is one of the strongest predictors of motor outcomes following stroke. CST-LL is typically calculated by using a probabilistic map of the CST originating from the primary motor cortex (M1). However, higher order motor areas also have projections that contribute to the CST and motor control. In this retrospective study, we examined whether evaluating CST-LL from additional motor origins is more strongly associated with post-stroke motor severity than using CST-LL originating from M1 only. We found that lesion load to both the ventral premotor (PMv) cortex and M1 were more strongly related to stroke motor severity indexed by Fugl-Meyer Assessment cut-off scores than CST-LL of M1 alone, suggesting that higher order motor regions add clinical relevance to motor impairment. </jats:p>

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