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Journal articles on the topic 'Corticospinal tract'

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Published: 4 June 2021
Last updated: 11 March 2023

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1

Jang, Sung Ho, Young Hwan Ahn, Seong Ho Kim, and Chul Hoon Chang. "Corticospinal Tract Restoration." Journal of Computer Assisted Tomography 31, no. 6 (November 2007): 901–4. http://dx.doi.org/10.1097/rct.0b013e31804089a6.

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2

Joosten, Elbert A. J. "Corticospinal tract regrowth." Progress in Neurobiology 53, no. 1 (September 1997): 1–25. http://dx.doi.org/10.1016/s0301-0082(97)00024-5.

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3

Chong, Catherine D., and Todd J. Schwedt. "Migraine affects white-matter tract integrity: A diffusion-tensor imaging study." Cephalalgia 35, no. 13 (February 23, 2015): 1162–71. http://dx.doi.org/10.1177/0333102415573513.

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Background Specific white-matter tract alterations in migraine remain to be elucidated. Using diffusion tensor imaging (DTI), this study investigated whether the integrity of white-matter tracts that underlie regions of the “pain matrix” is altered in migraine and interrogated whether the number of years lived with migraine modifies fibertract structure. Methods Global probabilistic tractography was used to assess the anterior thalamic radiations, the corticospinal tracts and the inferior longitudinal fasciculi in 23 adults with migraine and 18 healthy controls. Results Migraine patients show greater mean diffusivity (MD) in the left and right anterior thalamic radiations, the left corticospinal tract, and the right inferior longitudinal fasciculus tract. Migraine patients also show greater radial diffusivity (RD) in the left anterior thalamic radiations, the left corticospinal tract as well as the left and right inferior longitudinal fasciculus tracts. No group fractional anisotropy (FA) differences were identified for any tracts. Migraineurs showed a positive correlation between years lived with migraine and MD in the right anterior thalamic radiations ( r = 0.517; p = 0.012) and the left corticospinal tract ( r = 0.468; p = 0.024). Conclusion Results indicate that white-matter integrity is altered in migraine and that longer migraine history is positively correlated with greater alterations in tract integrity.
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4

Bertucco, Matteo, and Sudarshan Dayanidhi. "Can the period of postnatal codevelopment of the rubrospinal and corticospinal systems provide new insights into refinement of limb movement?" Journal of Neurophysiology 113, no. 3 (February 1, 2015): 681–83. http://dx.doi.org/10.1152/jn.00442.2014.

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The corticospinal and the rubrospinal tracts are thought to synergistically contribute to the limb control during motor development. Williams et al. ( J Neurosci 34: 4432–4441, 2014) demonstrate that the postnatal maturation of red nucleus motor map and the rubrospinal tract develops earlier than the corticospinal tract, to support early forelimb control. They have two distinct phases of maturation; a “precorticospinal” phase characterized by development of the rubrospinal system, and a “cocorticospinal” phase where they overlap with corticospinal development.
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Millichap, J. Gordon. "Corticospinal Tract in Newborns." Pediatric Neurology Briefs 4, no. 2 (February 1, 1990): 14. http://dx.doi.org/10.15844/pedneurbriefs-4-2-8.

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6

Taylor, J. L., and S. C. Gandevia. "Noninvasive stimulation of the human corticospinal tract." Journal of Applied Physiology 96, no. 4 (April 2004): 1496–503. http://dx.doi.org/10.1152/japplphysiol.01116.2003.

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Spinal tracts can be stimulated noninvasively in human subjects by passing a high-voltage stimulus between the mastoids or by magnetic stimulation over the back of the head. The stimulus probably activates the corticospinal tract at the cervicomedullary junction (pyramidal decussation) and evokes large, short-latency motor responses in the arm muscles. These responses have a large monosynaptic component. Responses in leg muscles can be elicited by cervicomedullary junction stimulation or by stimulation over the cervical or thoracic spine. Because nerve roots are more easily activated than spinal tracts, stimulus spread to motor axons can occur. Facilitation of responses by voluntary activity confirms that the responses are evoked synaptically. Stimulation of the corticospinal tract is useful in studies of central conduction and studies of the behavior of motoneurons during different tasks. It also provides an important comparison to allow interpretation of changes in responses to stimulation of the motor cortex. The major drawback to the use of electrical stimulation of the corticospinal tract is that each stimulus is transiently painful.
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Gorgoraptis, Nikos, Claudia AM Wheeler-Kingshott, Thomas M. Jenkins, Daniel R. Altmann, David H. Miller, Alan J. Thompson, and Olga Ciccarelli. "Combining tractography and cortical measures to test system-specific hypotheses in multiple sclerosis." Multiple Sclerosis Journal 16, no. 5 (March 9, 2010): 555–65. http://dx.doi.org/10.1177/1352458510362440.

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The objective was to test three motor system-specific hypotheses in multiple sclerosis patients: (i) corticospinal tract and primary motor cortex imaging measures differ between multiple sclerosis patients and controls; (ii) in patients, these measures correlate with disability; (iii) in patients, corticospinal tract measures correlate with measures of the ipsilateral primary motor cortex. Eleven multiple sclerosis patients with a history of hemiparesis attributable to a lesion within the contralateral corticospinal tract, and 12 controls were studied. We used two advanced imaging techniques: (i) diffusion-based probabilistic tractography, to obtain connectivity and fractional anisotropy of the corticospinal tract; and (ii) FreeSurfer, to measure volume, thickness, surface area, and curvature of precentral and paracentral cortices. Differences in these measures between patients and controls, and relationships between each other and to clinical scores, were investigated. Patients showed lower corticospinal tract fractional anisotropy and smaller volume and surface area of the precentral gyrus than controls. In patients, corticospinal tract connectivity and paracentral cortical volume, surface area, and curvature were lower with increasing disability; lower connectivity of the affected corticospinal tract was associated with greater surface area of the ipsilateral paracentral cortex. Corticospinal tract connectivity and new measures of the primary motor cortex, such as surface area and curvature, reflect the underlying white and grey matter damage that contributes to disability. The correlation between lower connectivity of the affected corticospinal tract and greater surface area of the ipsilateral paracentral cortex suggests the possibility of cortical adaptation. Combining tractography and cortical measures is a useful approach in testing hypotheses which are specific to clinically relevant functional systems in multiple sclerosis, and can be applied to other neurological diseases.
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8

Hodge, Jacquie, Bradley Goodyear, Helen Carlson, Xing-Chang Wei, and Adam Kirton. "Segmental Diffusion Properties of the Corticospinal Tract and Motor Outcome in Hemiparetic Children With Perinatal Stroke." Journal of Child Neurology 32, no. 6 (March 22, 2017): 550–59. http://dx.doi.org/10.1177/0883073817696815.

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Perinatal stroke injures developing motor systems, resulting in hemiparetic cerebral palsy. Diffusion tensor imaging can explore structural connectivity. We used diffusion tensor imaging to assess corticospinal tract diffusion in hemiparetic children with perinatal stroke. Twenty-eight children (6-18 years) with unilateral stroke underwent diffusion tensor imaging. Four corticospinal tract assessments included full tract, partial tract, minitract and region of interest. Diffusion characteristics (fractional anisotropy, mean, axial, and radial diffusivity) were calculated. Ratios (lesioned/nonlesioned) were compared across segments and to validated long-term motor outcomes (Pediatric Stroke Outcome Measure, Assisting Hand Assessment, Melbourne Assessment). Fractional anisotropy and radial diffusivity ratios decreased as tract size decreased, while mean diffusivity showed consistent symmetry. Poor motor outcomes were associated with lower fractional anisotropy in all segments and radial diffusivity correlated with both Assisting Hand Assessment and Melbourne Assessment. Diffusion imaging of segmented corticospinal tracts is feasible in hemiparetic children with perinatal stroke. Correlations with disability support clinical relevance and utility in model development for personalized rehabilitation.
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9

Lotan, Eyal, Ido Tavor, Daniel Barazany, Shani Ben-Amitay, Chen Hoffmann, Galia Tsarfaty, Yaniv Assaf, and David Tanne. "Selective atrophy of the connected deepest cortical layers following small subcortical infarct." Neurology 92, no. 6 (January 11, 2019): e567-e575. http://dx.doi.org/10.1212/wnl.0000000000006884.

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ObjectiveTo explore whether in patients with chronic small subcortical infarct the cortical layers of the connected cortex are differentially affected and whether these differences correlate with clinical symptomatology.MethodsTwenty patients with a history of chronic small subcortical infarct affecting the corticospinal tracts and 15 healthy controls were included. Connected primary motor cortex was identified with tractography starting from infarct. T1-component probability maps were calculated from T1 relaxation 3T MRI, dividing the cortex into 5 laminar gaussian classes.ResultsFocal cortical thinning was observed in the connected cortex and specifically only in its deepest laminar class compared to the nonaffected mirrored cortex (p < 0.001). There was loss of microstructural integrity of the affected corticospinal tract with increased mean diffusivity and decreased fractional anisotropy compared to the contralateral nonaffected tract (p ≤ 0.002). Clinical scores were correlated with microstructural damage of the corticospinal tracts and with thinning of the cortex and specifically only its deepest laminar class (p < 0.001). No differences were found in the laminar thickness pattern of the bilateral primary motor cortices or in the microstructural integrity of the bilateral corticospinal tracts in the healthy controls.ConclusionOur results support the concept of secondary neurodegeneration of connected primary motor cortex after a small subcortical infarct affecting the corticospinal tract, with observations that the main cortical thinning occurs in the deepest cortex and that the clinical symptomatology is correlated with this cortical atrophy pattern. Our findings may contribute to a better understanding of structural reorganization and functional outcomes after stroke.
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10

Bergsland, Niels, Maria Marcella Laganà, Eleonora Tavazzi, Matteo Caffini, Paola Tortorella, Francesca Baglio, Giuseppe Baselli, and Marco Rovaris. "Corticospinal tract integrity is related to primary motor cortex thinning in relapsing–remitting multiple sclerosis." Multiple Sclerosis Journal 21, no. 14 (March 19, 2015): 1771–80. http://dx.doi.org/10.1177/1352458515576985.

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Background: The relationship between white matter injury and cortical atrophy development in relapsing–remitting multiple sclerosis (RRMS) remains unclear. Objectives: To investigate the associations between corticospinal tract integrity and cortical morphology measures of the primary motor cortex in RRMS patients and healthy controls. Methods: 51 RRMS patients and 30 healthy controls underwent MRI examination for cortical reconstruction and assessment of corticospinal tract integrity. Partial correlation and multiple linear regression analyses were used to investigate the associations of focal and normal appearing white matter (NAWM) injury of the corticospinal tract with thickness and surface area measures of the primary motor cortex. Relationships between MRI measures and clinical disability as assessed by the Expanded Disability Status Scale and disease duration were also investigated. Results: In patients only, decreased cortical thickness was related to increased corticospinal tract NAWM mean, axial and radial diffusivities in addition to corticospinal tract lesion volume. The final multiple linear regression model for PMC thickness retained only NAWM axial diffusivity as a significant predictor (adjusted R2= 0.270, p= 0.001). Clinical measures were associated with NAWM corticospinal tract integrity measures. Conclusions: Primary motor cortex thinning in RRMS is related to alterations in connected white matter and is best explained by decreased NAWM integrity.
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11

Karibe, Hiroshi, Hiroaki Shimizu, Teiji Tominaga, Keiji Koshu, and Takashi Yoshimoto. "Diffusion-weighted magnetic resonance imaging in the early evaluation of corticospinal tract injury to predict functional motor outcome in patients with deep intracerebral hemorrhage." Journal of Neurosurgery 92, no. 1 (January 2000): 58–63. http://dx.doi.org/10.3171/jns.2000.92.1.0058.

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Object. Diffusion-weighted (DW) magnetic resonance imaging was used to visualize corticospinal tract injury in patients with deep intracerebral hemorrhage (ICH), and the results were used to predict motor impairment of the extremities.Methods. Twenty-eight patients with deep ICH (17 men and 11 women, mean age 58 ± 14 years) were examined. The volume of the ICH was assessed on initial computerized tomography scans. Twelve patients had ICH volumes of 40 ml or more and were treated surgically, and 16 patients who had an ICH volume of less than 40 ml were treated medically. Initial corticospinal tract injury was classified into four grades according to the anatomical relationship between the corticospinal tract and the ICH on DW images. Motor impairment of both the upper and lower extremities was assessed at admission and 1 month poststroke by using the National Institutes of Health Stroke Scale. The extent of correlation was determined between motor impairment and corticospinal tract injury.Initial corticospinal tract injury was not correlated with the impairment of extremities at admission but was closely correlated with motor impairment of the upper (r = 0.843, p < 0.001) and lower (r = 0.868, p < 0.001) extremities at 1 month poststroke. Impairment of the upper extremities correlated better with anterior than with posterior corticospinal tract injury (r = 0.911 compared with r = 0.600), and impairment of the lower extremities correlated better with posterior than with anterior injury (r = 0.890 compared with r = 0.787).Conclusions. Early evaluation of corticospinal tract injury based on DW imaging can provide predictive value for motor functional outcome in patients with deep ICH.
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12

Domi, Trish, Gabrielle deVeber, Manohar Shroff, Elizabeth Kouzmitcheva, Daune L. MacGregor, and Adam Kirton. "Corticospinal Tract Pre-Wallerian Degeneration." Stroke 40, no. 3 (March 2009): 780–87. http://dx.doi.org/10.1161/strokeaha.108.529958.

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13

Ingram, D. A., and M. Swash. "HUMAN CORTICOSPINAL TRACT CONDUCTION VELOCITY." Lancet 326, no. 8468 (December 1985): 1369. http://dx.doi.org/10.1016/s0140-6736(85)92667-4.

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14

Friesen, AC, SA Detombe, P. Doyle-Pettypiece, H. Haddad, W. Ng, K. Gurr, C. Bailey, et al. "P.172 Diffusion MRI characteristics change in select cerebral white matter tracts after decompressive surgery for degenerative cervical myelopathy." Canadian Journal of Neurological Sciences / Journal Canadien des Sciences Neurologiques 48, s3 (November 2021): S69. http://dx.doi.org/10.1017/cjn.2021.448.

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Background: Degenerative cervical myelopathy is characterized by progressive compression of the spinal cord resulting in debilitating loss of dexterity, independent ambulation, and sphincter control. Diffusion tensor imaging (DTI) has shown that, compared to healthy controls, myelopathy patients have decreased integrity of the corticospinal tracts and corpus callosum (Bernabeu-Sanz et al, 2020). Methods: Twenty-six myelopathy patients consented to cerebral diffusion tensor imaging (3 Tesla, 32 directions, b=1000) preoperatively, as well as 6-weeks, 12-weeks, and 6-months postoperatively. Average mean diffusivity (MD), fractional anisotropy (FA), radial diffusivity (RD), and axial diffusivity (AD) were measured in the corticospinal tracts, forceps major, and forceps minor. Results: Both MD and RD decreased from 6-12 weeks postoperatively in the right corticospinal tract. The forceps major of the corpus callosum showed an initial postoperative increase in MD followed by a subsequent increase in FA and decrease in RD 3-6 months postoperatively. The AD of the forceps major increased both immediately and 3-6 months postoperatively. Conclusions: Changes in microstructural integrity of the corticospinal tract and forceps major over the postoperative recovery period suggest a pattern of recovery in myelopathy patients. This study is the first to report postoperative DTI changes in myelopathy-relevant white matter tracts in the brain.
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15

Qiu, Ming-guo, Jing-na Zhang, Ye Zhang, Qi-yu Li, Bing Xie, and Jian Wang. "Diffusion Tensor Imaging-Based Research on Human White Matter Anatomy." Scientific World Journal 2012 (2012): 1–6. http://dx.doi.org/10.1100/2012/530432.

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The aim of this study is to investigate the white matter by the diffusion tensor imaging and the Chinese visible human dataset and to provide the 3D anatomical data of the corticospinal tract for the neurosurgical planning by studying the probabilistic maps and the reproducibility of the corticospinal tract. Diffusion tensor images and high-resolution T1-weighted images of 15 healthy volunteers were acquired; the DTI data were processed using DtiStudio and FSL software. The FA and color FA maps were compared with the sectional images of the Chinese visible human dataset. The probability maps of the corticospinal tract were generated as a quantitative measure of reproducibility for each voxel of the stereotaxic space. The fibers displayed by the diffusion tensor imaging were well consistent with the sectional images of the Chinese visible human dataset and the existing anatomical knowledge. The three-dimensional architecture of the white matter fibers could be clearly visualized on the diffusion tensor tractography. The diffusion tensor tractography can establish the 3D probability maps of the corticospinal tract, in which the degree of intersubject reproducibility of the corticospinal tract is consistent with the previous architectonic report. DTI is a reliable method of studying the fiber connectivity in human brain, but it is difficult to identify the tiny fibers. The probability maps are useful for evaluating and identifying the corticospinal tract in the DTI, providing anatomical information for the preoperative planning and improving the accuracy of surgical risk assessments preoperatively.
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Muramatsu, Ken, Satoshi Shimo, Toru Tamaki, Masako Ikutomo, and Masatoshi Niwa. "Functional and Structural Changes in the Corticospinal Tract of Streptozotocin-Induced Diabetic Rats." International Journal of Molecular Sciences 22, no. 18 (September 19, 2021): 10123. http://dx.doi.org/10.3390/ijms221810123.

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This study aimed to reveal functional and morphological changes in the corticospinal tract, a pathway shown to be susceptible to diabetes. Type 1 diabetes was induced in 13-week-old male Wistar rats administered streptozotocin. Twenty-three weeks after streptozotocin injection, diabetic animals and age-matched control animals were used to demonstrate the conduction velocity of the corticospinal tract. Other animals were used for morphometric analyses of the base of the dorsal funiculus of the corticospinal tract in the spinal cord using both optical and electron microscopy. The conduction velocity of the corticospinal tract decreased in the lumbar spinal cord in the diabetic animal, although it did not decrease in the cervical spinal cord. Furthermore, atrophy of the fibers of the base of the dorsal funiculus was observed along their entire length, with an increase in the g-ratio in the lumbar spinal cord in the diabetic animal. This study indicates that the corticospinal tract fibers projecting to the lumbar spinal cord experience a decrease in conduction velocity at the lumbar spinal cord of these axons in diabetic animals, likely caused by a combination of axonal atrophy and an increased g-ratio due to thinning of the myelin sheath.
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Lee, Sang Yoon, Si Hyun Kang, Don-Kyu Kim, Kyung Mook Seo, Hee Joon Ro, and Jae Kyun Kim. "Changes in the corticospinal tract after wearing prosthesis in bilateral transtibial amputation." Prosthetics and Orthotics International 41, no. 5 (January 17, 2017): 507–11. http://dx.doi.org/10.1177/0309364616684216.

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Background:After amputation, the brain is known to be reorganized especially in the primary motor cortex. We report a case to show changes in the corticospinal tract in a patient with serial bilateral transtibial amputations using diffusion tensor imaging.Case Description and Methods:A 78-year-old man had a transtibial amputation on his left side in 2008 and he underwent a right transtibial amputation in 2011. An initial brain magnetic resonance imaging with a diffusion tensor imaging was performed before starting rehabilitation on his right transtibial prosthesis, and a follow-up magnetic resonance imaging with diffusion tensor imaging was performed 2 years after this.Findings and Outcomes:In the initial diffusion tensor imaging, the number of fiber lines in his right corticospinal tract was larger than that in his left corticospinal tract. At follow-up diffusion tensor imaging, there was no definite difference in the number of fiber lines between both corticospinal tracts.Conclusion:We found that side-to-side corticospinal tract differences were equalized after using bilateral prostheses.Clinical relevanceThis case report suggests that diffusion tensor imaging tractography could be a useful method to understand corticomotor reorganization after using prosthesis in transtibial amputation.
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18

Klyuev, E. A., G. E. Sheiko, M. G. Dunaev, E. V. Lobanova, M. V. Rasteryaeva, and E. D. Sharabrin. "Neurovisualization features of brain anatomy in children with spastic cerebral palsy revealed by magnetic resonance tractography." Bulletin of Siberian Medicine 20, no. 3 (October 22, 2021): 54–61. http://dx.doi.org/10.20538/1682-0363-2021-3-54-61.

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Aim. To perform quantitative evaluation of the degree of white matter tract abnormalities in children with spastic cerebral palsy by magnetic resonance tractography to determine severity of the disease, as well as to carry out a dynamic assessment of treatment effectiveness.Materials and methods. The study included 46 children (32 males, 14 females; average age 5.4 ± 1.1 years). The participants were divided into two groups. The experimental group consisted of 23 children with spastic cerebral palsy. The control group included 23 children without any neurological disorder. Examination of the brain was performed on the Siemens Essenza 1,5 Т system (Siemens, Germany) and included magnetic resonance tractography to reconstruct the major white matter tracts. The number of fibers, average fractional anisotropy value, apparent diffusion coefficient, and coefficient of myelination of major white matter tracts in the brain were calculated and analyzed.Results. We found a significant difference in the above-stated parameters between the groups. The experimental group showed a decrease in the absolute number of fibers at the central and posterior segments of the corpus callosum, corticospinal tracts, and left inferior longitudinal fasciculus. Besides, we detected a decrease in fractional anisotropy at 2–5 segments of the corpus callosum and right lateral corticospinal tract, an increase in the apparent diffusion coefficient at 2, 4, and 5 segments of the corpus callosum and left lateral corticospinal tract, and a decrease in the myelination coefficient in all the examined tracts, except for superior longitudinal fasciculus. We revealed a positive correlation between the intensity of the motor disturbance and the coefficient of myelination at the anterior corpus callosum and inferior longitudinal fasciculus.Conclusion. Magnetic resonance tractography is an informative technique for unbiased evaluation of white matter tract anatomy, as well the level and degree of motor tract damage. The most useful characteristics of white matter tract anatomy are the absolute number of fibers in the tract, fractional anisotropy, and coefficient of myelination. Some of them correlated with the intensity of motor disturbance, so they can be regarded as potential predictors of rehabilitation potential.
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19

Li, Rui, Hongfang Sun, Hongjuan Hao, Yali Liu, Yang Zhang, Tianran Zhang, Guangbin Wang, and Ming Wang. "White matter integrity in patients with classic trigeminal neuralgia: a multi-node automated fiber tract quantification study." Journal of International Medical Research 49, no. 10 (October 2021): 030006052110470. http://dx.doi.org/10.1177/03000605211047071.

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Objective To study the characteristics of point-by-point destruction of white matter tracts in patients using automated fiber tract quantification (AFQ). Methods Thirty-four classic trigeminal neuralgia (CTN) patients and 34 healthy control (HC) subjects underwent 3.0 T diffusion tensor magnetic resonance imaging and T1-weighted imaging. The fractional anisotropy (FA) and mean diffusivity (MD) of 100 nodes of 20 fiber tracts were analyzed by AFQ, and the correlations of the FA and MD with the visual analogue scale (VAS) pain score were assessed. Results The FA values of the left thalamic radiation (middle segment), left corticospinal tract, callosum forceps minor, and right uncinate fasciculus were significantly lower in CTN patients than in the HC group. The MD of the left thalamic tract (middle segment), left corticospinal tract, right superior longitudinal fasciculus, and left superior longitudinal fasciculus (anterior segment) were significantly higher in the CTN group. Additionally, the VAS pain score in CTN patients was positively correlated with FA and negatively correlated with MD. Conclusion Specific fiber tract nodes were damaged in CTN patients, which was related to the VAS pain score. Multi-node quantitative studies of fiber tract damage are valuable for understanding the white matter tract damage pattern in CTN patients.
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Stommel, E. W., J. A. Cohen, K. Abe, Y. C. Lee, R. Markus, and A. Hughes. "MRI in ALS: Corticospinal tract hyperintensity." Neurology 63, no. 3 (August 9, 2004): 596–97. http://dx.doi.org/10.1212/wnl.63.3.596-a.

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21

Lie, C., J. G. Hirsch, C. Roßmanith, M. G. Hennerici, and A. Gass. "Clinicotopographical Correlation of Corticospinal Tract Stroke." Stroke 35, no. 1 (January 2004): 86–92. http://dx.doi.org/10.1161/01.str.0000106912.09663.eb.

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Lee, Y. C., R. Markus, and A. Hughes. "MRI in ALS: Corticospinal tract hyperintensity." Neurology 61, no. 11 (December 8, 2003): 1600. http://dx.doi.org/10.1212/01.wnl.0000096015.48322.2a.

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23

Phillips, O., F. Squitieri, C. Sanchez-Castaneda, F. Elifani, A. Griguoli, V. Maglione, C. Caltagirone, U. Sabatini, and M. Di Paola. "The Corticospinal Tract in Huntington's Disease." Cerebral Cortex 25, no. 9 (April 4, 2014): 2670–82. http://dx.doi.org/10.1093/cercor/bhu065.

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24

Pallud, J., B. Devaux, C. Daumas-Duport, C. Oppenheim, and F. X. Roux. "Glioma dissemination along the corticospinal tract." Journal of Neuro-Oncology 73, no. 3 (July 2005): 239–40. http://dx.doi.org/10.1007/s11060-005-0378-x.

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25

Boelmans, Kai, Jörn Kaufmann, Nils Bodammer, Hans-Jochen Heinze, and Ludwig Niehaus. "Corticospinal Tract Atrophy in Corticobasal Degeneration." Archives of Neurology 63, no. 3 (March 1, 2006): 462. http://dx.doi.org/10.1001/archneur.63.3.462.

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26

Honeycutt, Claire Fletcher, Michael Kharouta, and Eric Jon Perreault. "Evidence for reticulospinal contributions to coordinated finger movements in humans." Journal of Neurophysiology 110, no. 7 (October 1, 2013): 1476–83. http://dx.doi.org/10.1152/jn.00866.2012.

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The reticulospinal tract was recently shown to have synaptic connections to the intrinsic muscles of the fingers in nonhuman primates, indicating it may contribute to hand function long thought to be controlled exclusively through corticospinal pathways. Our objective was to obtain evidence supporting the hypothesis that these same anatomical connections exist in humans. startReact, an involuntary release of a planned movement via the startle reflex, provides a noninvasive means to examine the reticulospinal tract in humans. We found that startReact was triggered during coordinated grasp but not individuated finger movements. This result suggests that the reticulospinal tract does have connections to the intrinsic muscles of the fingers in humans but its functional role is limited to coordinated movement of the whole hand. These results do not diminish the well-established role of corticospinal pathways in the control of hand movement. Indeed, they cement the significance of corticospinal pathways in individuated finger movement control. Still, these results point to an updated and expanded view of distal hand control where reticulospinal and corticospinal pathways work in parallel to generate a large repertoire of diverse, coordinated movement in the hand. Finally, the presence of reticulospinal pathways to the muscles of the hand makes this pathway an attractive therapeutic target for clinical populations where the corticospinal tract is absent or injured.
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Kraskov, Alexander, Stuart Baker, Demetris Soteropoulos, Peter Kirkwood, and Roger Lemon. "The Corticospinal Discrepancy: Where are all the Slow Pyramidal Tract Neurons?" Cerebral Cortex 29, no. 9 (October 25, 2018): 3977–81. http://dx.doi.org/10.1093/cercor/bhy278.

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Abstract This feature article focuses on the discrepancy between the distribution of axon diameters within the primate corticospinal tract, determined neuroanatomically, and the distribution of axonal conduction velocities within the same tract, determined electrophysiologically. We point out the importance of resolving this discrepancy for a complete understanding of corticospinal functions, and discuss the various explanations for the mismatch between anatomy and physiology.
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Firmin, L., P. Field, M. A. Maier, A. Kraskov, P. A. Kirkwood, K. Nakajima, R. N. Lemon, and M. Glickstein. "Axon diameters and conduction velocities in the macaque pyramidal tract." Journal of Neurophysiology 112, no. 6 (September 15, 2014): 1229–40. http://dx.doi.org/10.1152/jn.00720.2013.

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Small axons far outnumber larger fibers in the corticospinal tract, but the function of these small axons remains poorly understood. This is because they are difficult to identify, and therefore their physiology remains obscure. To assess the extent of the mismatch between anatomic and physiological measures, we compared conduction time and velocity in a large number of macaque corticospinal neurons with the distribution of axon diameters at the level of the medullary pyramid, using both light and electron microscopy. At the electron microscopic level, a total of 4,172 axons were sampled from 2 adult male macaque monkeys. We confirmed that there were virtually no unmyelinated fibers in the pyramidal tract. About 14% of pyramidal tract axons had a diameter smaller than 0.50 μm (including myelin sheath), most of these remaining undetected using light microscopy, and 52% were smaller than 1 μm. In the electrophysiological study, we determined the distribution of antidromic latencies of pyramidal tract neurons, recorded in primary motor cortex, ventral premotor cortex, and supplementary motor area and identified by pyramidal tract stimulation (799 pyramidal tract neurons, 7 adult awake macaques) or orthodromically from corticospinal axons recorded at the mid-cervical spinal level (192 axons, 5 adult anesthetized macaques). The distribution of antidromic and orthodromic latencies of corticospinal neurons was strongly biased toward those with large, fast-conducting axons. Axons smaller than 3 μm and with a conduction velocity below 18 m/s were grossly underrepresented in our electrophysiological recordings, and those below 1 μm (6 m/s) were probably not represented at all. The identity, location, and function of the majority of corticospinal neurons with small, slowly conducting axons remains unknown.
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Klineova, Sylvia, Rebecca Farber, Catarina Saiote, Colleen Farrell, Bradley N. Delman, Lawrence N. Tanenbaum, Joshua Friedman, Matilde Inglese, Fred D. Lublin, and Stephen Krieger. "Relationship between timed 25-foot walk and diffusion tensor imaging in multiple sclerosis." Multiple Sclerosis Journal - Experimental, Translational and Clinical 2 (January 1, 2016): 205521731665536. http://dx.doi.org/10.1177/2055217316655365.

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Objective/Background The majority of multiple sclerosis patients experience impaired walking ability, which impacts quality of life. Timed 25-foot walk is commonly used to gauge gait impairment but results can be broadly variable. Objective biological markers that correlate closely with patients’ disability are needed. Diffusion tensor imaging, quantifying fiber tract integrity, might provide such information. In this project we analyzed relationships between timed 25-foot walk, conventional and diffusion tensor imaging magnetic resonance imaging markers. Design/Methods A cohort of gait impaired multiple sclerosis patients underwent brain and cervical spinal cord magnetic resonance imaging. Diffusion tensor imaging mean diffusivity and fractional anisotropy were measured on the brain corticospinal tracts and spinal restricted field of vision at C2/3. We analyzed relationships between baseline timed 25-foot walk, conventional and diffusion tensor imaging magnetic resonance imaging markers. Results Multivariate linear regression analysis showed a statistically significant association between several magnetic resonance imaging and diffusion tensor imaging metrics and timed 25-foot walk: brain mean diffusivity corticospinal tracts (p = 0.004), brain corticospinal tracts axial and radial diffusivity (P = 0.004 and 0.02), grey matter volume (p = 0.05), white matter volume (p = 0.03) and normalized brain volume (P = 0.01). The linear regression model containing mean diffusivity corticospinal tracts and controlled for gait assistance was the best fit model (p = 0.004). Conclusions Our results suggest an association between diffusion tensor imaging metrics and gait impairment, evidenced by brain mean diffusivity corticospinal tracts and timed 25-foot walk.
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Sarnat, Harvey B. "Do the Corticospinal and Corticobulbar Tracts Mediate Functions in the Human Newborn?" Canadian Journal of Neurological Sciences / Journal Canadien des Sciences Neurologiques 16, no. 2 (May 1989): 157–60. http://dx.doi.org/10.1017/s0317167100028821.

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ABSTRACT:Unlike the numerous dispersed bulbospinal pathways that are already well myelinated at term, the more compact corticospinal and corticobulbar tracts are only beginning their myelination cycle in late gestation and do not complete it until two years of age. During this same period, these pathways also develop extensive ramification of terminal axonal segments, growth of collateral axons, and proliferation of synapses. Despite their immaturity in the fullterm human newborn, several proposed functions may be attributed to the descending pathways from the neonatal cerebral cortex: a) a contribution to the differential development of passive muscle tone and resting postures; in general they function as an antagonist to the “subcorticospinal pathways” in mediating proximal flexion and distal extension, except for the rubrospinal tract which is probably synergistic with the corticospinal tract; b) enhancement of tactile reflexes originating in the brainstem and spinal cord, including suck and swallow; c) relay of epileptic activity of cortical origin; d) inhibition of complex stereotyped motor reflexes including many phenomena formerly termed “subtle seizures”; e) a possible influence on muscle maturation, particularly in relaying cerebellar impulses that modify the histochemical differentiation of myofibres. However, the bulbospinal tracts are probably more influential on muscle development. The corticospinal and corticobulbar tracts subserve different needs in the newborn than at older ages, but are functionally important pathways even at birth.
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Rollins, Nancy K., Timothy N. Booth, and Maria H. Chahrour. "Variability of Ponto-cerebellar Fibers by Diffusion Tensor Imaging in Diverse Brain Malformations." Journal of Child Neurology 32, no. 3 (December 5, 2016): 271–85. http://dx.doi.org/10.1177/0883073816680734.

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To describe pontine axonal anomalies across diverse brain malformations. Institutional review board–approved review of magnetic resonance imaging (MRI) and genetic testing of 31 children with brain malformations and abnormal pons by diffusion tensor imaging. Anomalous dorsal pontocerebellar tracts were seen in mid-hindbrain anomalies and in diffuse malformations of cortical development including lissencephaly, gyral disorganization with dysplastic basal ganglia, presumed congenital fibrosis of extraocular muscles type 3, and in callosal agenesis without malformations of cortical development. Heterotopic and hypoplastic corticospinal tracts were seen in callosal agenesis and in focal malformations of cortical development. There were no patterns by chromosomal microarray analysis in the non-lissencephalic brains. In lissencephaly, there was no relationship between severity, deletion size, or appearance of the pontocerebellar tract. Pontine axonal anomalies may relate to defects in precerebellar neuronal migration, chemotactic signaling of the pontine neurons, and/or corticospinal tract pathfinding and collateral branching not detectable with routine genetic testing.
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32

Abdel Razek, Ahmed Abdel Khalek, Lamiaa El-Serougy, Amani Ezzat, Hany Eldawoody, and Ahmad El-Morsy. "Interobserver Agreement of White Matter Tract Involvement in Gliomas with Diffusion Tensor Tractography." Journal of Neurological Surgery Part A: Central European Neurosurgery 81, no. 03 (November 27, 2019): 233–37. http://dx.doi.org/10.1055/s-0039-1700560.

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Abstract Aim To assess with diffusion tensor tractography (DTT) the interobserver agreement of white matter tract involvement in patients with gliomas. Patient and Methods A prospective study was conducted on 35 patients (21 male, 14 female; age: 2–71 years) with gliomas that underwent DTT. Two independent readers assessed the patterns of involvement of the corticospinal tract, corpus callosum, optic radiation, and fasciculi as normal, edematous, displaced, infiltrated, or disrupted. Results Overall interobserver agreement of involvement of the white matter tracts was excellent (κ = 0.93; 95% confidence interval [CI], 0.91–0.95; p = 0.001). Interobserver agreement was excellent for involvement of corticospinal tracts (κ = 0.81; 95% CI, 0.57–1.00; p = 0.001), corpus callosum (κ = 0.91; 95% CI, 0.75–1.00; p = 0.001), optic radiation (κ = 0.77; 95% CI, 0.53–0.98; p = 0.001), and fasciculi (κ = 0.912; 95% CI, 0.81–0.99; p = 0.001. The interobserver agreement was excellent for tract edema (κ = 0.81; 95% CI, 0.57–1.00; p = 0.001), tract displacement (κ = 0.91; 95% CI, 0.75–1.00; p = 0.001), tract disruption (κ = 0.81; 95% CI, 0.57–1.00; p = 0.001), and good for tract infiltration (κ = 0.77; 95% CI, 0.53–0.98; p = 0.001). The interobserver agreement was excellent for white matter tract involvement in patients with low-grade gliomas (κ = 0.81; 95% CI, 0.57–1.00; p = 0.001) and high-grade gliomas (κ = 0.91; 95% CI, 0.75–1.00; p = 0.001). Conclusion DTT is a reliable and reproducible method for assessment of white matter tract involvement in patients with low- and high-grade gliomas.
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33

Wolpaw, J. R., and J. H. Kaas. "Taking sides: Corticospinal tract plasticity during development." Neurology 57, no. 9 (November 13, 2001): 1530–31. http://dx.doi.org/10.1212/wnl.57.9.1530.

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Chang, Won Hyuk, Young-Bum Kim, Suk Hoon Ohn, Chang-hyun Park, Sung Tae Kim, and Yun-Hee Kim. "Double decussated ipsilateral corticospinal tract in schizencephaly." NeuroReport 20, no. 16 (October 2009): 1434–38. http://dx.doi.org/10.1097/wnr.0b013e328331483d.

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35

Yeo, Sang Seok, and Sung Ho Jang. "Medullary Decussation of the Lateral Corticospinal Tract." European Neurology 66, no. 5 (2011): 296–97. http://dx.doi.org/10.1159/000331636.

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36

Davies, E., M. J. Sharrard, A. Raghavan, and S. R. Mordekar. "P05.6 Corticospinal Tract Calcification in Krabbe's Disease." European Journal of Paediatric Neurology 15 (May 2011): S50—S51. http://dx.doi.org/10.1016/s1090-3798(11)70170-2.

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37

Deletis, Vedran, and Francesco Sala. "Subcortical stimulation (mapping) of the corticospinal tract." Clinical Neurophysiology 122, no. 7 (July 2011): 1275–76. http://dx.doi.org/10.1016/j.clinph.2011.01.001.

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38

Muller, K., V. Hömberg, and H.-G. Lenard. "Noninvasive assessment of naturation of corticospinal tract." Pediatric Research 26, no. 5 (November 1989): 506. http://dx.doi.org/10.1203/00006450-198911000-00042.

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39

Mills, Kerry R., and Nicholas M. F. Murray. "Corticospinal tract conduction time in multiple sclerosis." Annals of Neurology 18, no. 5 (November 1985): 601–5. http://dx.doi.org/10.1002/ana.410180514.

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40

Partanen, Juhani, Juhani Merikanto, Hannu Kokki, Riitta Kilpeläinen, and Anu Koistinen. "Antidromic corticospinal tract potential of the brain." Clinical Neurophysiology 111, no. 3 (March 2000): 489–95. http://dx.doi.org/10.1016/s1388-2457(99)00264-3.

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41

Manogaran, Praveena, Irene Vavasour, Michael Borich, Shannon H. Kolind, Alex P. Lange, Alexander Rauscher, Lara Boyd, David KB Li, and Anthony Traboulsee. "Corticospinal tract integrity measured using transcranial magnetic stimulation and magnetic resonance imaging in neuromyelitis optica and multiple sclerosis." Multiple Sclerosis Journal 22, no. 1 (May 6, 2015): 43–50. http://dx.doi.org/10.1177/1352458515579441.

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Background: Both multiple sclerosis (MS) and neuromyelitis optica (NMO) can present with transverse myelitis; however, NMO symptoms are usually more severe and may present with more extensive axonal loss. Transcranial magnetic stimulation (TMS)-based input–output recruitment curves can quantitatively assess the excitability of corticospinal tract pathways and myelin water imaging can quantify the amount of myelin within this same pathway. Objective: To compare differential effects of MS and NMO on TMS recruitment curves and myelin water imaging. Methods: Ten healthy controls, 10 individuals with MS and 10 individuals with NMO completed clinical assessments, a TMS assessment and magnetic resonance imaging scan to measure recruitment curves and myelin water fraction in the corticospinal tract. Results: Individuals with NMO had lower recruitment curve slopes (mean 13.6±6 μV/%) than MS (23.6±11 μV/%) and controls (21.9±9 μV/%, analysis of variance (ANOVA) P=0.05). Corticospinal tract myelin water fraction was lower in individuals with NMO (mean 0.17±0.02) compared to MS (0.19±0.02) and controls (0.20±0.02, ANOVA P=0.0006). Conclusion: Corticospinal pathway damage in individuals with NMO was evident by reduced recruitment curve slope and lower myelin water fraction. These specific measures of corticospinal function and structure may be used to obtain a better understanding and monitor brain injury caused by inflammatory central nervous system disorders.
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42

Uematsu, Junji, Kyokazu Ono, Tsunekazu Yamano, and Morimi Shimada. "Development of corticospinal tract fibers and their plasticity I: Quantitative analysis of the developing corticospinal tract in mice." Brain and Development 18, no. 1 (January 1996): 29–34. http://dx.doi.org/10.1016/0387-7604(95)00102-6.

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43

Ku, Jerry, Daniel Mendelsohn, Jason Chew, Jason Shewchuk, Charles Dong, and Ryojo Akagami. "Ipsilateral Motor Innervation Discovered Incidentally on Intraoperative Monitoring: A Case Report." Neurosurgery 80, no. 3 (January 10, 2017): E194—E200. http://dx.doi.org/10.1093/neuros/nyw074.

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Abstract BACKGROUND AND IMPORTANCE: Lesions in the corticospinal tract above the decussation at the medullary pyramids almost universally produce contralateral deficits. Rare cases of supratentorial lesions causing ipsilateral motor deficits have been reported previously, but only ever found secondary to stroke or congenital pyramidal tract malformations. CLINICAL PRESENTATION: Herein, we report a case of ipsilateral corticospinal tract innervation discovered incidentally with intraoperative monitoring during a microsurgical resection of a vestibular schwannoma. Intraoperative monitoring with electrical transcranial stimulation of the frontal scalp triggered motor-evoked potentials in the ipsilateral arms. The uncrossed pathways were later confirmed with MRI tractography using diffusion tensor imaging. CONCLUSION: To the best of our knowledge, this is the first case of isolated ipsilateral motor innervation of the corticospinal tract discovered incidentally during a neurosurgical procedure. Given the increasing use of intraoperative monitoring, this case underscores the importance of cautious interpretation of seemingly discordant neurophysiological findings. Once technical issues have been ruled out, ipsilateral motor innervation may be considered as a possible explanation and neurosurgeons should be aware of the existence of this rare anatomic variant.
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44

Betti, Sonia, Marta Fedele, Umberto Castiello, Luisa Sartori, and Sanja Budisavljević. "Corticospinal excitability and conductivity are related to the anatomy of the corticospinal tract." Brain Structure and Function 227, no. 3 (October 25, 2021): 1155–64. http://dx.doi.org/10.1007/s00429-021-02410-9.

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45

Nazarova, Maria, Sofya Kulikova, Michael A. Piradov, Alena S. Limonova, Larisa A. Dobrynina, Rodion N. Konovalov, Pavel A. Novikov, et al. "Multimodal Assessment of the Motor System in Patients With Chronic Ischemic Stroke." Stroke 52, no. 1 (January 2021): 241–49. http://dx.doi.org/10.1161/strokeaha.119.028832.

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Background and Purpose: Despite continuing efforts in the multimodal assessment of the motor system after stroke, conclusive findings on the complementarity of functional and structural metrics of the ipsilesional corticospinal tract integrity and the role of the contralesional hemisphere are still lacking. This research aimed to find the best combination of motor system metrics, allowing the classification of patients into 3 predefined groups of upper limb motor recovery. Methods: We enrolled 35 chronic ischemic stroke patients (mean 47 [26–66] years old, 29 [6–58] months poststroke) with a single supratentorial lesion and unilateral upper extremity weakness. Patients were divided into 3 groups, depending on upper limb motor recovery: good, moderate, and bad. Nonparametric statistical tests and regression analysis were used to investigate the relationships among microstructural (fractional anisotropy (FA) ratio of the corticospinal tracts at the internal capsule (IC) level (classic method) and along the length of the tracts (Fréchet distance), and of the corpus callosum) and functional (motor evoked potentials [MEPs] for 2 hand muscles) motor system metrics. Stratification rules were also tested using a decision tree classifier. Results: IC FA ratio in the IC and MEP absence were both equally discriminative of the bad motor outcome (96% accuracy). For the 3 recovery groups’ classification, the best parameter combination was IC FA ratio and the Fréchet distance between the contralesional and ipsilesional corticospinal tract FA profiles (91% accuracy). No other metrics had any additional value for patients’ classification. MEP presence differed for 2 investigated muscles. Conclusions: This study demonstrates that better separation between 3 motor recovery groups may be achieved when considering the similarity between corticospinal tract FA profiles along its length in addition to region of interest-based assessment and lesion load calculation. Additionally, IC FA ratio and MEP absence are equally important markers for poor recovery, while for MEP probing it may be important to investigate more than one hand muscle.
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Lee, Jae Min, Jong Bum Kim, Dong Hyun Byun, and Su Min Son. "Disruption of the Corticospinal Tract in Patients with Acute Lymphoblastic Leukemia: A Case Series." Children 9, no. 8 (August 12, 2022): 1223. http://dx.doi.org/10.3390/children9081223.

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Three patients who exhibited hemiplegic symptoms on conventional brain magnetic resonance imaging (MRI), during maintenance treatment for acute lymphoblastic leukemia, are reported. All patients exhibited unilateral motor weakness and poor hand function during chemotherapy. Conventional MRI revealed no definite abnormal lesions. However, in diffusion tensor tractography, the affected corticospinal tract on the contralateral side, consistently with clinical dysfunction, revealed disrupted integrity, decreased fractional anisotropy, and increased apparent diffusion coefficient compared to the results of the unaffected side or control participants. Control participants matched for age, sex, and duration from leukemia diagnosis, who underwent chemotherapy but had no motor impairments, exhibited preserved integrity of both corticospinal tracts. Diffusion tensor tractography can help evaluate patients with acute lymphoblastic leukemia and neurological dysfunction.
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Lahti, Katri, Riitta Parkkola, Päivi Jääsaari, Leena Haataja, Virva Saunavaara, Annarilla Ahtola, Mikael Ekblad, et al. "The impact of susceptibility correction on diffusion metrics in adolescents." Pediatric Radiology 51, no. 8 (April 24, 2021): 1471–80. http://dx.doi.org/10.1007/s00247-021-05000-3.

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Abstract Background Diffusion tensor imaging is a widely used imaging method of brain white matter, but it is prone to imaging artifacts. The data corrections can affect the measured values. Objective To explore the impact of susceptibility correction on diffusion metrics. Materials and methods A cohort of 27 healthy adolescents (18 boys, 9 girls, mean age 12.7 years) underwent 3-T MRI, and we collected two diffusion data sets (anterior–posterior). The data were processed both with and without susceptibility artifact correction. We derived fractional anisotropy, mean diffusivity and histogram data of fiber length distribution from both the corrected and uncorrected data, which were collected from the corpus callosum, corticospinal tract and cingulum bilaterally. Results Fractional anisotropy and mean diffusivity values significantly differed when comparing the pathways in all measured tracts. The fractional anisotropy values were lower and the mean diffusivity values higher in the susceptibility-corrected data than in the uncorrected data. We found a significant difference in total tract length in the corpus callosum and the corticospinal tract. Conclusion This study indicates that susceptibility correction has a significant effect on measured fractional anisotropy, and on mean diffusivity values and tract lengths. To receive reliable and comparable results, the correction should be used systematically.
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Rozand, Vianney, Jonathon W. Senefeld, Christopher W. Sundberg, Ashleigh E. Smith, and Sandra K. Hunter. "Differential effects of aging and physical activity on corticospinal excitability of upper and lower limb muscles." Journal of Neurophysiology 122, no. 1 (July 1, 2019): 241–50. http://dx.doi.org/10.1152/jn.00077.2019.

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Corticospinal tract excitability can be altered by age, physical activity (PA), and possibly sex, but whether these effects differ between upper and lower limb muscles is unknown. We determined the influence of age, PA, and sex on corticospinal excitability of an upper limb and a lower limb muscle during submaximal contractions by comparing stimulus-response curves of motor evoked potentials (MEPs). Transcranial magnetic stimulation (TMS) was used to evoke stimulus-response curves in active muscles by incrementally increasing the stimulator intensity from below the active motor threshold (AMT) until a plateau in MEP amplitudes was achieved. Stimulus-response curves were analyzed from the first dorsal interosseous (FDI) of 30 young (23.9 ± 3.8 yr) and 33 older (72.6 ± 5.6 yr) men and women and the vastus lateralis (VL) of 13 young (23.2 ± 2.2 yr) and 25 older (72.7 ± 5.5 yr) men and women. Corticospinal excitability was determined by fitting the curves with a four-parameter sigmoidal curve and calculating the maximal slope (slopemax). PA was assessed with triaxial accelerometry, and participants were dichotomized into high-PA (>10,000 steps/day, n = 15) or low-PA (<10,000 steps/day, n = 43) groups. Young adults had larger FDI MEP amplitudes (% maximum amplitude of compound muscle action potential) at higher TMS intensities (120–150% AMT) and greater slopemax than older adults ( P < 0.05), with no differences between high- and low-PA groups ( P > 0.05). VL MEP amplitudes and slopemax, however, were lower in the high-PA than low-PA participants, with no age or sex differences. These data suggest that aging and PA, but not sex, differentially influence the excitability of the corticospinal tracts projecting to muscles of the upper compared with the lower limb. NEW & NOTEWORTHY Excitability of the corticospinal tract projecting to the first dorsal interosseous assessed with transcranial magnetic stimulation was reduced with age but independent of regular physical activity (steps/day) and sex of the individual. In contrast, corticospinal excitability of the vastus lateralis was not affected by age but was reduced in individuals achieving more than the physical activity recommendations of 10,000 steps/day. Aging and activity differentially affect corticospinal excitability of upper and lower limb muscles.
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Kaneko, Nobuyuki, Warren W. Boling, Takaharu Shonai, Kazumi Ohmori, Yoshiaki Shiokawa, Hiroki Kurita, and Takanori Fukushima. "Delineation of the Safe Zone in Surgery of Sylvian Insular Triangle: Morphometric Analysis and Magnetic Resonance Imaging Study." Operative Neurosurgery 70, suppl_2 (August 9, 2011): ons290—ons299. http://dx.doi.org/10.1227/neu.0b013e3182315112.

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ABSTRACT BACKGROUND: Surgery within the insula carries significant risk of morbidity, particularly hemiparesis, because of the difficulty in detecting the internal capsule boundaries. OBJECTIVE: We analyzed the anatomy of the insula and identified landmarks anticipated to facilitate surgery for intrinsic insular lesions. METHODS: Insular region anatomy was studied in 11 cadaveric brains harvested within 72 hours postmortem. MRI of the specimens was acquired using 3.0 T with T2-weighting and 25 directions of diffusion tensor imaging. Landmarks easily recognizable during surgery were identified on the surface of the insula. The interrelationships between surface landmarks and critical structures were analyzed. RESULTS: The posterior inferior insular point (PIIP) and the upper central insular point (UCIP) were newly established as landmarks on the insula. The PIIP corresponded to the obvious bend in the posterior long insular gyrus. The UCIP is the meeting point between the central insular sulcus and superior peri-insular sulcus. The corticospinal tract was identified as a high-intensity area in the posterior limb of the internal capsule on T2-weighted imaging and its course confirmed with diffusion tensor imaging tractography. The corticospinal tract took a course deep to the posterosuperior insula on T2-weighted imaging, 4.8 mm from the UCIP and 6.2 mm from the PIIP. CONCLUSION: The posterosuperior part of the insula forms the region at greatest risk to corticospinal tract injury. The PIIP and UCIP are crucial to understanding the relationship of the insula with the posterior limb of the internal capsule including the corticospinal tract.
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Šoda, Joško, Sanda Pavelin, Igor Vujović, and Maja Rogić Vidaković. "Assessment of Motor Evoked Potentials in Multiple Sclerosis." Sensors 23, no. 1 (January 2, 2023): 497. http://dx.doi.org/10.3390/s23010497.

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Transcranial magnetic stimulation (TMS) is a noninvasive technique mainly used for the assessment of corticospinal tract integrity and excitability of the primary motor cortices. Motor evoked potentials (MEPs) play a pivotal role in TMS studies. TMS clinical guidelines, concerning the use and interpretation of MEPs in diagnosing and monitoring corticospinal tract integrity in people with multiple sclerosis (pwMS), were established almost ten years ago and refer mainly to the use of TMS implementation; this comprises the magnetic stimulator connected to a standard EMG unit, with the positioning of the coil performed by using the external landmarks on the head. The aim of the present work was to conduct a narrative literature review on the MEP assessment and outcome measures in clinical and research settings, assessed by TMS Methodological characteristics of different TMS system implementations (TMS without navigation, line-navigated TMS and e-field-navigated TMS); these were discussed in the context of mapping the corticospinal tract integrity in MS. An MEP assessment of two case reports, by using an e-field-navigated TMS, was presented; the results of the correspondence between the e-field-navigated TMS with MRI, and the EDSS classifications were presented. Practical and technical guiding principles for the improvement of TMS studies in MEP assessment for MS are discussed, suggesting the use of e-field TMS assessment in the sense that it can improve the accuracy of corticospinal tract integrity testing by providing a more objective correspondence of the neurophysiological (e-field-navigated TMS) and clinical (Expanded Disability Status Scale—EDSS) classifications.
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