Abstract WMP42: Exploring The Neural Basis Of Prognostic Tools For Upper Limb Recovery After Stroke: <i>Lesion Topography Of SAFE And Other Medical Research Council Scale Scores</i>
Bibliographic record
Abstract
Background: The Medical Research Council (MRC) scale is used to assess the impact of stroke on muscle strength. Shoulder abduction and finger extension, collectively (SAFE), have been suggested to have prognostic value for stroke outcomes (e.g. PREP-2), and been recommended for use in screening for clinical trials. Few studies have assessed the neuroanatomy associated with SAFE, and other upper extremity MRC scores after stroke. In this study, we used voxel-based lesion symptom mapping (VLSM) to assess lesion locations associated with worse SAFE scores, as well as other movements assessed by the MRC scale. Methods: A trained therapist assessed 12 individual MRC scores at the: shoulder (flexion, extension, abduction, internal and external rotation), elbow (flexion and extension), wrist (flexion and extension) and fingers (flexion, extension and abduction). Clinical neuroimaging (MRI and/or CT) was collected for all participants, and lesioned voxels traced by trained assessors and normalized to a standard template space. VLSM analysis was conducted for all 12 MRC scale scores, and SAFE score, using NiiStat. Only voxels lesioned in >10% of participants were tested. Results: We recruited 226 stroke participants at 2 weeks post-stroke (mean age=62.6; Males=147; Right Hemisphere=131; Ischemic=199, Hemorrhagic=27). VLSM analysis showed that worse SAFE scores were significantly associated with lesions in voxels in the left and right corona radiata, adjacent and dorsal to the lateral ventricles, and consistent with the upper portions of the corticospinal tract in each hemisphere. Additionally, voxels in the putamen were also significantly associated with worse SAFE scores. Interestingly, all other MRC scores were also associated with similar lesion topography to SAFE. Conclusion: This work demonstrates a consistent association between SAFE scores and corticospinal tract damage. The integrity of the corticospinal tract has frequently been suggested as a biomarker of stroke recovery. These findings shed light on why SAFE might be a valuable prognostic tool for stroke recovery, and a quick and efficient screening tool for clinical trials. Despite increasing use of SAFE, other muscle weakness, assessed by the MRC scale, is also represented by the same neuroanatomic regions and may share similar prognostic abilities. Continued investigation into effective prognostic tools for upper-limb recovery is warranted.
Fetched live from OpenAlex and de-inverted. Abstracts are not stored in this database: the inverted indexes are 8.6 GB of the frame’s 9.3 GB of text, and the host has 13 GB free.
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 | 0.001 | 0.002 |
| 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) | 0.005 | 0.001 |
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".