Our objective was to determine the relationship between spasticity development (identified with TSRT) and Magnetic Resonance Imaging (MRI)-based measures of brain damage location and descending tract integrity in the first 12 weeks after stroke onset. We hypothesized that greater stroke-related damage in the brain and descending motor tracts (cortico- and reticulospinal) would be associated with the development of greater spasticity (larger angular range of spasticity).
Individuals with a first ischemic/hemorrhagic unilateral stroke aged ≤ 85 yr were included. Participants were assessed for 12 wks with a follow-up conducted at week 16 using clinical assessments to evaluate sensorimotor deficits in the elbow/ankle and TSRT angle. Brain and spinal cord imaging was acquired using both anatomical and diffusion tensor MRI. Anatomical MRI data was analyzed using manual lesion segmentation scans, and functional MRI data was analyzed using the Spinal Cord Toolbox.
TSRT detected the presence of abnormal reflex activity 6 wks ± 4 wks before clinical scales. Diminished cortico- and reticulospinal tract integrity was related to lower (more impaired) TSRT values (r=0.65-0.80).
Implementing this novel spasticity measurement could lead to earlier detection of spasticity and allow for more accurate prediction of which individuals will develop spasticity after stroke.
This information may be used to apply earlier and more tailored treatments to minimize the impact of spasticity on recovery and, ultimately, increase functional independence in those living with stroke.
biomarkers
stroke
