Diffusion tensor MR imaging of the pyramidal tract can predict the need for orthosis in hemiplegic patients with hemorrhagic stroke

Diffusion tensor magnetic resonance (MR) imaging was used to evaluate motor functions in stroke patients. The aim of this study was to clarify whether imaging can be used to predict orthotic needs in patients with hemiplegia. We studied 25 patients (age range, 16–78 years) with intracerebral hemorrhages (putamen 15, thalamus 7, frontal subcortex 3). Diffusion tensor MR imaging was undertaken on admission at rehabilitation hospital for stroke patients. The fractional anisotropy (FA) value of the pyramidal tract was calculated. We compared the FA value in the ROI of the cerebral peduncle with the necessity for orthosis at discharge from the rehabilitation hospital. As a result, the FA values of the affected side in patients who needed orthosis at discharge were lower than those in patients who did not need orthosis. There was no significant difference in the FA values of the unaffected side. We concluded that the need for orthosis in patients with hemiplegia after stroke rehabilitation could be predicted using the diffusion tensor MR images of corticospinal tractography.