Relationship of the Nigrostriatal Tract with the Motor Function and the Corticospinal Tract in Chronic Hemiparetic Stroke Patients: A Diffusion Tensor Imaging Study

Abstract

This study investigated the relationship of the nigrostriatal tract (NST) with motor function and the corticospinal tract (CST) using diffusion tensor tractography in chronic hemiparetic stroke patients. Forty-three consecutive patients with putaminal hemorrhage in the chronic stage were recruited. The Motricity Index was used to evaluate the motor function of affected hemiparetic extremities. The fractional anisotropy and the tract volume of ipsilesional NST and ipsilesional CST were acquired. The tract volume (Rho = 0.824) of ipsilesional NST and fractional anisotropy (r = 0.682) and the tract volume (Rho = 0.886) of ipsilesional CST showed a strong positive correlation with the Motricity Index score. The fractional anisotropy of ipsilesional NST showed moderate positive correlations with the fractional anisotropy (r = 0.449) and tract volume (Rho = 0.353) of ipsilesional CST. The tract volume of ipsilesional NST showed strong positive correlations with the fractional anisotropy (Rho = 0.716) and the tract volume (Rho = 0.799) of ipsilesional CST. The regression model showed that the tract volumes of ipsilesional NST and ipsilesional CST were positively associated with the Motricity Index score (Adjusted R2 = 0.763, F = 45.998). Mediation analysis showed that the tract volume of ipsilesional CST partially mediated the effects of the tract volume of ipsilesional NST on the Motricity Index score (z = 3.34). A close relationship was found between ipsilesional NST and the motor function of affected extremities in chronic hemiparetic patients with putaminal hemorrhage. Moreover, ipsilesional NST influenced the motor function of affected extremities indirectly through ipsilesional CST.