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Does injury of the thalamocortical connection between the mediodorsal nucleus of the thalamus and the dorsolateral prefrontal cortex affect motor recovery after cerebral infarct?

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Abstract

We assessed the state of the thalamocortical connection between the mediodorsal nucleus (MD) and the dorsolateral prefrontal cortex (DLPFC) in patients with corona radiata infarct using diffusion tensor tractography (DTT). Altogether, 110 patients with corona radiata infarct were recruited, all of whom underwent DTT at an early stage following infarct onset. Based on the integrity of CST (CST+: CST was preserved around the infarct, CST−: CST was interrupted by the infarct) and the integrity of thalamocortical connection between the MD of thalamus and the DLPFC (DLPFC+: the connection was preserved, DLPFC−: the connection was interrupted), patients were divided into 4 groups: CST+/DLPFC+ (37 patients), CST+/DLPFC− (21 patients), CST−/DLPFC+ (25 patients), and CST−/DLPFC− (27 patients) groups. Motor function was evaluated using the upper Motricity Index (MI), lower MI, modified Brunnstrom classification, and the functional ambulation category at baseline and at 6 months post-onset. In patients with preserved CST integrity, the status of the thalamocortical connection had no impact on the assessed motor outcomes at 6 months post-stroke. However, in patients with disrupted CST integrity, those with preserved thalamocortical connection integrity had significantly higher motor function scores in all assessed outcomes 6 months post-stroke than those with disrupted thalamocortical connection integrity. The preservation or disruption of the thalamocortical connection between the MD of the thalamus and the DLPFC is an important factor for motor function recovery when CST integrity is also disrupted.

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Funding

The present study was supported by a National Research Foundation of Korea grant funded by the Korean government (Grain No. NRF-2019R1F1A1061348).

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Authors and Affiliations

  1. Department of Physical Medicine and Rehabilitation, College of Medicine, Yeungnam University, 317-1, Daemyungdong, Namku, Taegu, 705-717, Republic of Korea

    Kyu Tae Choi & Min Cheol Chang

  2. Department of Medical Statistics, College of Medicine, Catholic University of Daegu, Daegu, Republic of Korea

    Sang Gyu Kwak

Authors
  1. Kyu Tae Choi
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  2. Sang Gyu Kwak
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  3. Min Cheol Chang
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Contributions

KTC contributed with: concept and design, analysis and interpretation of data, and drafting of the manuscript. CMC contributed with: analysis and interpretation of data, and drafting of the manuscript, and revision of the manuscript.

Corresponding author

Correspondence to Min Cheol Chang.

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All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

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Written informed consent was obtained from all individual participants included in the study.

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Choi, K.T., Kwak, S.G. & Chang, M.C. Does injury of the thalamocortical connection between the mediodorsal nucleus of the thalamus and the dorsolateral prefrontal cortex affect motor recovery after cerebral infarct?. Acta Neurol Belg 121, 921–926 (2021). https://doi.org/10.1007/s13760-020-01309-2

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  • DOI: https://doi.org/10.1007/s13760-020-01309-2

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