Structural and Functional Correlates of Hand Recovery Following Childhood Stroke
Bibliographic record
Abstract
Following stroke in children, there is a wide range of motor recovery. This study examined the role of the corticospinal tract (CST) and its association with motor outcome of the hand in children following arterial ischemic stroke (AIS). The corticospinal tract was assessed several ways, using the appropriate imaging modalities.The primary hypothesis was that the extent of motor recovery in the stroke affected hand would be associated with two factors: 1) the extent of anatomical damage to the stroke affected corticospinal tract, and, 2) the extent and pattern of functional reorganization within the motor system. Children with AIS in the middle cerebral artery territory, occurring after the age of 2, were assessed for motor function with the validated Pediatric Stroke Outcome Measure. The presence of corticospinal tract damage was determined using conventional MRI to assess Wallerian degeneration, and diffusion tensor imaging (DTI) to quantify damage at the microstructural level. These measures were done in chronic phase following stroke. In the acute phase, (1 - 10 days post stroke), the presence of diffusion weighted imaging (DWI) signal abnormalities in the corticospinal tract were determined. Finally, neural activation patterns were evaluated using functional MRI to assess the location and extent of functional reorganization of the hand following stroke. These activation patterns were also assessed to determine the association with corticospinal tract integrity, and motor outcome. We found the integrity of the CST shows an association with motor outcome of the hand in pediatric stroke patients. Greater damage to the CST was associated with a greater motor deficit, suggesting that the level of motor skill recovery achieved in pediatric stroke patients relates to the gross morphological, and microstructural status of the CST. Integrity of the fibers in the CST also showed an association with the brain activation patterns. Greater damage to the CST was associated with a larger volume of activations during stroke affected hand use in the stroke affected hemisphere, and more severe outcome. The current study suggests that a structural and functional relationship exists in children with variable recovery of hand function following stroke. The use of complementary imaging techniques was effective in evaluating this relationship.
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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 | 0.002 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.001 | 0.001 |
| 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) | 0.001 | 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".