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Difference in Injury of the Corticospinal Tract and Spinothalamic Tract in Patients with Putaminal Hemorrhage
J Kor Phys Ther 2019;31(6):358-362
Published online December 30, 2019;  https://doi.org/10.18857/jkpt.2019.31.6.358
© 2019 The Korea Society of Physical Therapy.

Sung Ho Jang1, Jeong Pyo Seo2

1Department of Physical Medicine and Rehabilitation, College of Medicine, Yeungnam University, Daegu; 2Department of Physical Therapy, College of Health Sciences, Dankook University, Cheonan, Korea
Jeong Pyo Seo E-mail raphael0905@hanmail.net
Received November 4, 2019; Revised December 4, 2019; Accepted December 27, 2019.
This is an Open Access article distribute under the terms of the Creative Commons Attribution Non-commercial License (Http://creativecommons.org/license/by-nc/4.0.) which permits unrestricted non-commercial use, distribution,and reproduction in any medium, provided the original work is properly cited.
Abstract
Purpose: We investigated the difference in injury of the corticospinal tract (CST) and the spinothalamic tract (STT) in patients with putaminal hemorrhage, using diffusion tensor tractography (DTT).
Methods: Thirty one consecutive patients with PH and 34 control subjects were recruited for this study. DTT scanning was performed at early stage of PH (7-63 days), and the CST and STT were reconstructed using the Functional Magnetic Resonance Imaging of Brain (FMRIB) Software Library program. Injury of the CST and STT was defined in terms of the configuration or abnormal DTT parameters was more than 2 standard deviations lower than that of normal control subjects.
Results: Among 31 patients, all 31 patients (100%) had injury of the CTS, whereas 25 patients (80.6%) had injury of the STT: the incidence of CST injury was significantly higher than that of STT (p<0.05). In detail, 20 (64.5%) of 31 patients showed a discontinuation of the CST in the affected hemisphere; in contrast, 14 patients (45.2%) of 31 patients showed a discontinuation of the STT in the affected hemisphere. Regarding the FA value, 6 (19.4%) of 31 patients and 2 (6.4%) of 31 patients were found to have injury in the CST and STT, respectively. In terms of the fiber number, the same injury incidence was observed in 11 patients (35.5%) in both the CST and STT.
Conclusion: The greater vulnerability of the CST appears to be ascribed to the anatomical characteristics; the CST is located anteriorly to the center of the putamen compared with the STT.
Keywords : Stroke, Putaminal hemorrhage, Corticospinal tract, Spinothalamic tract, Diffusion tensor tractography.


December 2019, 31 (6)
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