Quantitative Prognostic Analysis of Upper Limb Motor Dysfunction After Stroke

Study Overview
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Brief Summary
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30% - 66% of stroke survivors have upper limb dysfunction. Effective rehabilitation can improve the prognosis, but the rehabilitation resources are limited. How to evaluate the prognosis early and formulate an individualized rehabilitation plan based on realistic expectations is still inconclusive. The current research shows that some brain network changes are related to the recovery of motor function. The dynamic connection of multi-modal and spatio-temporal fusion of motor network is helpful to the prognosis analysis of upper limb dyskinesia after stroke. 178 stroke patients will be included in this project. Fugl-Meyer motor function scale (upper limb part) and Action Research Arm Test (ARAT) will be evaluated at enrollment, 1month/3month/6month after onset. According to the results, the groups with good prognosis and poor prognosis will be distinguished; blood oxygen level dependent imaging and diffusion tensor imaging will be collected at the same time to compare the similarities and differences of the function and structural connection of the motion network; the correlation between interhemispheric connection, intrahemispheric connection, cross network connection of motor network and prognosis will be analyzed, the clinical and imaging features of different prognosis will be extracted. This study can provide scientific data support for the prognosis analysis of upper limb dysfunction after stroke, the improvement of rehabilitation clinical decision-making and the optimization of rehabilitation resource allocation.

Official Title
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The Prognostic Analysis of Upper Limb Motor Dysfunction After Stroke Based on Dynamic Connection of Motion Network

Conditions
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Stroke, Rehabilitation; Tobacco Use, Upper Extremity Dysfunction, Prognosis, Functional MRI

Intervention / Treatment
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* Other: no intervention


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: First stroke with upper limb motor dysfunction, Stable condition; 18 ≤age≤80 years old; The onset time was less than 3 weeks at the time of enrollment; Sign informed consent. Exclusion Criteria: Stroke patients with intracranial infection, multi-system atrophy and other central nervous system diseases; Combined with severe aphasia, visual spatial neglect and other cognitive impairment; Untreated spasm (Ashworth ≥ grade 2); Obvious joint contracture restricting the movement of upper limb; In vivo metal implants; Claustrophobia.

Ages Eligible for Study
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Minimum Age: 18 Years
Maximum Age: 80 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| good prognosis<br>Patients with higher Fugl-Meyer motor function scale (upper limb part) and higher Action Research Arm Test (ARAT) score. | Other: no intervention<br>* observational research<br>|
| poor prognosis<br>Patients with lower Fugl-Meyer motor function scale (upper limb part) and lower Action Research Arm Test (ARAT) score. | Other: no intervention<br>* observational research<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Motor assessment at early subacute phase | Fugl-Meyer Assessment for Upper Limb | 1 month after onset | 
| Motor assessment at subacute phase | Fugl-Meyer Assessment for Upper Limb | 3 months after onset | 
| Motor assessment at chronic phase | Fugl-Meyer Assessment for Upper Limb | 6 months after onset | 
| Functional assessment at early subacute phase | Action Research Arm Test | 1 month after onset | 
| Functional assessment at subacute phase | Action Research Arm Test | 3 months after onset | 
| Functional assessment at chronic phase | Action Research Arm Test | 6 months after onset | 
| The motion network of early subacute phase with functional MRI | The structural and functional connection of the motion network | 1 month after onset | 
| The motion network of subacute phase with functional MRI | The structural and functional connection of the motion network | 3 months after onset | 
| The motion network of chronic phase with functional MRI | The structural and functional connection of the motion network | 6 months after onset | 
| Correlation analysis between changes of motor function and changes of motor network | The correlation between interhemispheric connection, intrahemispheric connection, cross network connection of motor network and motor function prognosis will be analyzed | 1 month after onset, 3 months after onset, 6 months after onset |