Abstract 4033: Structural Integrity of the Corticospinal Tract Correlated with the Degree of Hand Recovery in Pediatric Patients Following Stroke
Bibliographic record
Abstract
Introduction: The objective was to investigate association of the corticospinal tract (CST) and the association with neurological outcome using Diffusion Tensor Imaging (DTI) to measure the structural integrity of the CST at the level of the cerebral peduncles and the descending CST (DCST) using a tractography based approach (Diffusion Tensor Tractography - DTT) in children with a range of recovery in hand function following arterial ischemic stroke. Methods: Structural integrity of the CST supplying the hand (DTI) and neurological outcome was evaluated in 11 patients and 8 controls. DTI: sequences were performed with 2 dimensional DW EPI, 25 directions, 1000 0b value, TR 8300 msec, TE ∼ 79msc, scan time: 5 minutes. CST integrity at the level of the peduncles was measured by drawing a region-of-interest (ROI) on the anterior cerebral peduncles (Kirton, 2007) and calculating Fractional Anisotropy ([FA], range 0=isotropic, 1=anisotropic) (FSL v4.1). Tract-based spatial statistics (TBSS) were used for CST reconstruction by drawing an ROI on single axial T1-weighted image in which the hand knob region was most noticeable as the initial seed point, and the second ROI on the single axial T1 weighted image in which the cerebral peduncle was most prominent. T-tests with Welch correction (for unequal variance) were used to compare the difference in the mean FA values of the ROIs between peduncles and the DCST in normal controls, and the stroke and non-stroke affected peduncles in patients. The correlation of the mean FA of the DCST and neurological outcome assessed with the sensori-motor subscale of the Pediatric Stroke Outcome Measure. Results: Patients and controls did not differ in age at acquisition (mean=9.61 vs 12.29). DTI: The mean FA values of the peduncles between patients and controls were found to differ between hemispheres (p= .006). The mean FA of the stroke affected (ipsilesional) (mean=.3912) peduncles were significantly lower than the non-affected peduncle (contralesional) (mean =.4336, p=.001). DTT: The tract based analyses also showed FA values (mean=.3197) in the stroke affected DCST were significantly lower than the unaffected (contralesional) DCST (mean=.4441). Correlation analysis a revealed a significant negative correlation between motor outcome and mean FA of the stroke affected DCST (P < 0.05) and the unaffected DCST (P < 0.05). Conclusions: Integrity of the fibers in the DCST shows an association with motor outcome of the hand in pediatric stroke patients. Greater damage to the DCST was associated with a greater motor deficit. The results of this study suggest that the level of motor skill recovery achieved in pediatric stroke patients relates to microstructural status of the DCST.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.000 | 0.001 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.001 | 0.000 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.004 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".