Article

The lateral corticospinal tract (CST) is one of the most important
neuronal pathways that mediate voluntary movements in the human brain. However,
little is known about the role of the lateral CST on the gait. We attempted to
investigate differences in gait pattern using a motion analysis system according
to the integrity of the contralateral CST, which was classified using diffusion
tensor tractography (DTT) in chronic hemiparetic stroke patients. METHODS: We
recruited 16 chronic hemiparetic stroke patients and 12 normal subjects for this
study. DTT findings of the CST for patients were classified into two groups:
group A (eight patients); the integrity of the CST was preserved, group B (eight
patients) - the CST was discontinued at or below the stroke lesion. We compared
variables of gait between group A, group B, and normal controls using the motion
analysis system. RESULTS: Group A and the control group showed a significantly
higher peak angle for ankle dorsiflexion, knee internal rotation, and hip
flexion, compared with group B (p < 0.05). On the other hand, the peak angle for
ankle plantarflexion/external rotation, knee flexion/abduction, and hip extension
of group A and group B were significantly lower than those of the control group
(p < 0.05). CONCLUSION: We found that severe injury of the contralateral CST
caused decreased movement of ankle dorsiflexion, knee internal rotation, and hip
flexion in chronic hemiparetic stroke patients. As a result, the circumduction
and abduction gait pattern in stroke patients is closely associated with severe
injury of the contralateral CST.

Langue : ANGLAIS