Effects of Diabetes on Motor Recovery after Cerebral Infarct: A Diffusion Tensor Imaging Study

Abstract

Objective: Little is known about the effects of diabetes on motor recovery after cerebral infarct. To address this question, we recruited patients with corona radiata infarct and controlled for the integrity of the corticospinal tract (CST) as determined by diffusion tensor tractography (DTT). Design: One hundred patients were recruited, and DTT was performed within 7 to 30 days of infarct onset. Based on the DTT findings (DTT+, CST was preserved around the infarct; DTT-, CST was interrupted by the infarct) and the presence (DM+) or absence (DM-) of diabetes, patients were divided into DTT+/DM- (36 patients), DTT+/DM+ (19 patients), DTT-/DM- (32 patients), and DTT-/DM+ (13 patients) groups. Six months after cerebral infarct, motor function on the affected side was evaluated for each patient via the upper motricity index (MI), lower MI, modified Brunnstrom classification (MBC), and functional ambulation category (FAC). Results: In the patients with a DTT+ finding, no motor function scores were significantly different between the DTT+/DM- and DTT+/DM+ groups at 6-month evaluation. However, in patients with DTT- finding, all motor function scores at the 6-month evaluation were significantly higher in the DTT-/DM- group than in the DTT-/DM+ group. Conclusion: When the CST is interrupted by a corona radiata infarct, recovery of motor function in patients with diabetes is more impaired than those without diabetes.