Corpus callosal microstructure predicts bimanual motor performance in chronic stroke survivors

Abstract

AO_SCPLOWBSTRACTC_SCPLOWMicrostructural changes in the corpus callosum are associated with more severe motor impairment in the paretic hand, poor recovery, and general disability. Considering its role in bimanual coordination, we suspected that these microstructural changes across the callosum may also be reflected in the performance of ecologically valid routine bimanual tasks. Thus, the purpose of this study was to determine if callosal microstructure predicts bimanual motor performance in chronic stroke survivors by examining the regions of the corpus callosum connecting both the sensorimotor and non-sensorimotor cortices. We examined the relationship between the fractional anisotropy across the CC and movement times for two self-initiated and self-paced bimanual tasks in 41 chronic stroke survivors. Using publicly available control datasets (n = 52), matched closely for acquisition parameters, we also explored the effect of stroke and age on callosal microstructure. There were two main findings: First, callosal microstructure was significantly associated with bimanual performance in chronic stroke survivors. Notably, a significant relationship was observed not only with the primary sensorimotor regions, but also regions of the premotor/supplementary motor and prefrontal regions. Second, chronic stroke survivors presented with significantly lower mean FA, compared to neurologically intact adults. We conclude that in mild-to-moderate chronic stroke survivors with relatively localized lesions to the motor areas, callosal microstructure can be expected to change in not only the primary sensorimotor region, but also more anteriorly in the secondary motor regions and the genu and is associated with performance on cooperative bimanual tasks. SignificanceA goal of rehabilitation after stroke is to promote the return to pre-stroke levels of upper limb function and use, predominantly characterized by coordinated bimanual activities. In this study, we find that in the chronic phase of stroke, microstructural disorganization within the corpus callosum predicts motor performance on real-world bimanual tasks and lends important insight into the indirect, remote effects of stroke. HO_SCPLOWIGHLIGHTSC_SCPLOWO_LIWe provide initial evidence that corpus callosal microstructure predicts performance on two self-initiated and self-paced bimanual tasks. C_LIO_LIAssociations were strongest for fibers connecting the primary sensorimotor cortices followed by the pre- and supplementary motor, and prefrontal cortices. C_LIO_LISignificant reductions in fractional anisotropy were observed in stroke survivors for all regions of the corpus callosum. C_LI