Introduction. Spasticity is a disabling complication of stroke.1, Aim of this study was to assess the prognostic value of brain lesions location as a predictor of spasticity development after stroke. Materials and methods. 51 patients (first-ever unilateral ischemic stroke) were recruited. Each patient’s T1 magnetic resonance imaging performed 1-4 weeks after the onset was collected. At 6 months after stroke we evaluated the muscle tone at the upper and lower limbs using the Modified Ashworth Scale (MAS).3 Brain lesions were mapped and located using MRIcro and MRIcroN software. For statistical purposes we described spasticity as absent/present. The affected limb was considered spastic if a score ≥ 1 and severely spastic if a score ≥ 3 was present in the MAS at any joint evaluated. Results. Brain lesions that showed a significant correlation with the development of spasticity after stroke involved the white matter (corona radiate, internal capsule), the basal ganglia (putamen, caudate, pallidum), the insula, the precentral gyrus, the Rolandic operculum, the frontal gyri, the frontal operculum, the thalamus. Lesions involving the subcortical white matter (corona radiate, internal capsule) and the basal ganglia (putamen, caudate, pallidum) showed a significant correlation with the development of severe spasticity after the onset. Conclusion. The present study shows that brain lesions’ location could be a predictor of the development of spasticity after stroke. In particular lesions involving the corona radiata, the internal capsule and the basal ganglia are related with the development of spasticity and severe spasticity after the onset.

Brain lesions and spasticity: a voxel-based lesion-symptom mapping analysis on 51 patients.

PICELLI, Alessandro;TAMBURIN, Stefano;VARALTA, Valentina;GANDOLFI, MariaLuisa;SMANIA, Nicola
2010

Abstract

Introduction. Spasticity is a disabling complication of stroke.1, Aim of this study was to assess the prognostic value of brain lesions location as a predictor of spasticity development after stroke. Materials and methods. 51 patients (first-ever unilateral ischemic stroke) were recruited. Each patient’s T1 magnetic resonance imaging performed 1-4 weeks after the onset was collected. At 6 months after stroke we evaluated the muscle tone at the upper and lower limbs using the Modified Ashworth Scale (MAS).3 Brain lesions were mapped and located using MRIcro and MRIcroN software. For statistical purposes we described spasticity as absent/present. The affected limb was considered spastic if a score ≥ 1 and severely spastic if a score ≥ 3 was present in the MAS at any joint evaluated. Results. Brain lesions that showed a significant correlation with the development of spasticity after stroke involved the white matter (corona radiate, internal capsule), the basal ganglia (putamen, caudate, pallidum), the insula, the precentral gyrus, the Rolandic operculum, the frontal gyri, the frontal operculum, the thalamus. Lesions involving the subcortical white matter (corona radiate, internal capsule) and the basal ganglia (putamen, caudate, pallidum) showed a significant correlation with the development of severe spasticity after the onset. Conclusion. The present study shows that brain lesions’ location could be a predictor of the development of spasticity after stroke. In particular lesions involving the corona radiata, the internal capsule and the basal ganglia are related with the development of spasticity and severe spasticity after the onset.
Spasticity, rehabilitation, prediction.
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Utilizza questo identificativo per citare o creare un link a questo documento: https://hdl.handle.net/11562/953550
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