Background. Corticospinal tract (CST) damage is considered a biomarker for stroke recovery. Several methods have been used to define CST damage and examine its relationship to motor performance, but which method is most useful remains unclear. Proprioceptive impairment also affects stroke recovery and may be related to CST damage. Methods. Robotic assessment quantified upper-limb motor and proprioceptive performance at 2 weeks and 6 months poststroke (n = 149). Three previously-established CST lesion metrics were calculated using clinical neuroimaging. Diffusion magnetic resonance imaging quantified CST microstructure in a subset of participants (n = 21). Statistical region of interest (sROI) analysis identified lesion locations associated with motor and proprioceptive deficits. Results. CST lesion metrics were moderately correlated with motor scores at 2 weeks and 6 months poststroke. CST fractional anisotropy (FA) was correlated with motor scores at 1 month poststroke, but not at 6 months. The FA ratio of the posterior limb of the internal capsule was not correlated with motor performance. CST lesion metrics were moderately correlated with proprioceptive scores at 2 weeks and 6 months poststroke. sROI analysis confirmed that CST damage was associated with motor and proprioceptive deficits and additionally found that putamen, internal capsule, and corticopontocerebellar tract lesions were associated with poor motor performance. Conclusions. Across all methods used to quantify CST damage, correlations with motor or proprioceptive performance were moderate at best. Future research is needed to identify complementary or alternative biomarkers to address the complexity and heterogeneity of stroke recovery.

中文翻译：

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比较 CST 病变指标作为中风后运动和本体感觉障碍恢复的生物标志物

背景。皮质脊髓束 (CST) 损伤被认为是中风恢复的生物标志物。已使用多种方法来定义 CST 损伤并检查其与运动性能的关系，但哪种方法最有用仍不清楚。本体感觉障碍也会影响中风的恢复，并且可能与 CST 损伤有关。方法。机器人评估量化了卒中后 2 周和 6 个月的上肢运动和本体感觉性能（n = 149）。使用临床神经影像学计算了三个先前建立的 CST 病变指标。扩散磁共振成像量化了一部分参与者 (n = 21) 的 CST 微观结构。感兴趣的统计区域 (sROI) 分析确定了与运动和本体感觉缺陷相关的病变位置。结果。CST 病变指标与卒中后 2 周和 6 个月的运动评分中度相关。CST 分数各向异性 (FA) 与卒中后 1 个月时的运动评分相关，但与 6 个月时无关。内囊后肢的 FA 比率与运动表现无关。CST 病变指标与卒中后 2 周和 6 个月的本体感受评分中度相关。sROI 分析证实 CST 损伤与运动和本体感觉缺陷有关，此外还发现壳核、内囊和皮质桥脑小脑束病变与较差的运动表现有关。结论。在用于量化 CST 损伤的所有方法中，与运动或本体感觉性能的相关性充其量是中等的。