Evidence map›Paper›PMID 41766678›Full record

ArticleNeurorehabilitation and neural repair2026

Optimizing the Approach to Calculating CST Lesion Load in Ischemic Stroke Patients for Understanding Motor Outcomes.

Brady J Williamson, Tyler Behymer, Anne Schwarz, Achala Vagal, Carolee J Winstein, Michael R Borich, Colleen Hanlon, Michael Dimyan, Adriana B Conforto, Fabrizio Piras and 11 more

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In one paragraph

Article in Neurorehabilitation and neural repair, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

0numbers the graph read from it
0cells of the map it votes in
0citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

0 citing papers in PubMed.

No citing paper in PubMed yet.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

21 authors.

Brady J WilliamsonUniversity of Cincinnati College of Medicine, Department of Radiology, Cincinnati, OH, USA.ORCID 0000-0002-1161-402X
Tyler BehymerUniversity of Cincinnati College of Medicine, Department of Radiology, Cincinnati, OH, USA.
Anne SchwarzCalifornia Rehabilitation Institute, Los Angeles, CA.
Achala VagalUniversity of Cincinnati College of Medicine, Department of Radiology, Cincinnati, OH, USA.
Carolee J WinsteinDivision of Biokinesiology and Physical Therapy, Herman Ostrow School of Dentistry, University of Southern California, Los Angeles, CA, USA.
Michael R BorichDivision of Physical Therapy, Department of Rehabilitation Medicine, Emory University School of Medicine, Atlanta, GA, USA.
Colleen HanlonBrainsway, Burlington, MA, USA.
Michael DimyanFood and Drug Administration, Silver Spring, MD, USA.
Adriana B ConfortoHospital das Clínicas, São Paulo University, São Paulo, Brazil, Hospital Israelita Albert Einstein, São Paulo, Brazil.ORCID 0000-0001-7869-3490
Fabrizio PirasClinical Neuroscience and Neurorehabilitation, IRCCS Santa Lucia Foundation, Rome, Italy.
Daniela VecchioClinical Neuroscience and Neurorehabilitation, IRCCS Santa Lucia Foundation, Rome, Italy.
Brenton HordacreInnovation, Implementation and Clinical Translation (IIMPACT) in Health, Allied Health and Human Performance, University of South Australia, Adelaide, Australia.ORCID 0000-0002-7129-6684
Lara A BoydDepartment of Physical Therapy, University of British Columbia, Vancouver, BC, Canada.
Jennifer K FerrisGerontology Research Centre, Simon Fraser University, Vancouver, BC, Canada.
Jessica M CassidyDivision of Physical Therapy, Department of Health Sciences, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA.ORCID 0000-0003-3469-0399
Sophia I ThomopoulosImaging Genetics Center, Mark and Mary Stevens Neuroimaging and Informatics Institute, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA.
Neda JahanshadImaging Genetics Center, Mark and Mary Stevens Neuroimaging and Informatics Institute, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA.
Paul M ThompsonImaging Genetics Center, Mark and Mary Stevens Neuroimaging and Informatics Institute, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA.
Mahir KhanChan Division of Occupational Science and Occupational Therapy, University of Southern California, Los Angeles, CA, USA.
Sook-Lei LiewImaging Genetics Center, Mark and Mary Stevens Neuroimaging and Informatics Institute, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA.ORCID 0000-0001-5935-4215
Steven C CramerCalifornia Rehabilitation Institute, Los Angeles, CA.ORCID 0000-0002-6214-6211

Funding

Training U54EB020403 · NIBIB · UNIVERSITY OF SOUTHERN CALIFORNIA · PI THOMPSON, PAUL M · 2014 to 2018
$10.1M
Genetic variation, stress, and functional outcomes after stroke rehabilitationR01NR015591 · NINR · UNIVERSITY OF CALIFORNIA-IRVINE · PI CRAMER, STEVEN C., HOLMAN, ELLEN ALISON · 2015 to 2020
$2.6M
NIBIB NIH HHS U54 EB020403NINR NIH HHS R01 NR015591
6 · The paper itself

Abstract

IntroductionCorticospinal tract lesion load (CST-LL) is a biomarker used for studying motor outcomes after stroke. However, the optimal method for calculating this metric is unknown.MethodsThis is a cross-sectional study of a large ischemic stroke cohort from the ENIGMA Stroke Recovery Consortium (n = 221; mean age = 59.8 years, 56% male) to compare 4 lesion load metrics across 3 CST templates. We then validate these findings in another large, independent stroke cohort (n = 125; mean age = 64.6 years, 54% male).ResultsResults indicate that variance in behavioral outcome was best explained using the maximum weighted cross-sectional overlap between lesion and the CST (Max-WLL), and when using an age-appropriate normative CST template (generated from the HCP Aging study). This was true both when the outcome was motor impairment, measured using the Fugl-Meyer Upper Extremity scale (FMUE, relative explained variance (REV) = 58.9%), and when it was global function, measured using the Barthel Index (BI, REV = 60%). In the validation cohort, FMUE results were replicated (REV = 47.6%).ConclusionThe findings indicate that Max-WLL, which represents the proportion of transected CST fibers, most accurately captures CST injury as it relates to motor and functional outcomes after stroke. Additionally, results suggest the importance of an age-appropriate template, a key consideration given that stroke is largely a disease of the elderly. Together, these findings provide an independently validated tool to optimize future research examining CST injury after stroke.

Indexed as

Brain IschemiaIschemic StrokePyramidal TractsStrokeAgedCross-Sectional StudiesFemaleHumansMagnetic Resonance ImagingMaleMiddle AgedRecovery of Functioncorticospinal tract (CST)functional outcomesischemic strokemotor outcomes

Identifiers

PMID41766678
PMCPMC12958443

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.