Objective. The relationship between white matter integrity and the brain-derived neurotrophic factor (BDNF) genotype and its effects on motor recovery after stroke are poorly understood. We investigated the values of fractional anisotropy (FA) in the corticospinal tract (CST), the intrahemispheric connection from the primary motor cortex to the ventral premotor cortex (M1PMv), and the interhemispheric connection via the corpus callosum (CC) in patients with the BDNF genotype from the acute to the subacute phase after stroke. Methods. The Fugl-Meyer assessment, upper extremity (FMA-UE), and tract-related FA were assessed at 2 weeks (T1) and 3 months (T2) after stroke using diffusion tensor imaging (DTI). Fifty-eight patients diagnosed with ischemic stroke were classified according to the BDNF genotype into a Val (valine homozygotes) or Met (methionine heterozygotes and homozygotes) group. Results. The Val group exhibited a larger reduction of FA values in the ipsilesional M1PMv than the Met group from T1 to T2. The FMA-UE at T2 was negatively correlated with FA of the contralesional M1PMv at T2 in the Val group but was positively correlated with FA of the ipsilesional CST and CC at T2 in the Met group. Conclusions. The integrity of the intra- and interhemispheric connections might be related to different processes of motor recovery dependent on the BDNF genotype. Thus, the BDNF genotype may need to be considered as a factor influencing neuroplasticity and functional recovery in patients with stroke. This trial is registered with http://www.clinicaltrials.gov: NCT03647787.

中文翻译：

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基于脑源性神经营养因子基因型的白质束微观结构完整性与中风后运动恢复之间的差异关系

客观的。白质完整性与脑源性神经营养因子（BDNF）基因型之间的关系及其对中风后运动恢复的影响知之甚少。我们研究了皮质脊髓束 (CST) 中的分数各向异性 (FA) 值、从初级运动皮层到腹侧前运动皮层 (M1PMv) 的半球内连接以及通过胼胝体 (CC) 的半球间连接。脑卒中后急性期至亚急性期的BDNF基因型。方法。使用扩散张量成像 (DTI) 在卒中后 2 周 (T1) 和 3 个月 (T2) 评估 Fugl-Meyer 评估、上肢 (FMA-UE) 和束相关 FA。58 名诊断为缺血性中风的患者根据BDNF基因型分为 Val（缬​​氨酸纯合子）或 Met（蛋氨酸杂合子和纯合子）组。结果。从T1到T2，Val组在同病灶M1PMv中表现出比Met组更大的FA值降低。Val 组中 T2 时的 FMA-UE 与 T2 时对侧 M1PMv 的 FA 呈负相关，而 Met 组中与 T2 时同侧 CST 和 CC 的 FA 呈正相关。结论。半球内和半球间连接的完整性可能与取决于BDNF基因型的运动恢复的不同过程有关。因此，BDNF基因型可能需要被视为影响中风患者神经可塑性和功能恢复的因素。该试验已在 http://www.clinicaltrials.gov 注册：NCT03647787。