Prediction of the motor prognosis with diffusion tensor imaging in hemorrhagic stroke: a meta-analysis

This paper investigates whether diffusion tensor imaging performed within 2 weeks of intracerebral hemorrhage onset could predict the motor outcome by categorizing previous diffusion tensor imaging studies based on the time-point of performing diffusion tensor imaging (<2 weeks and ≥2 weeks after intracerebral hemorrhage onset). A comprehensive database search on PubMed, Embase, Cochrane Library, and SCOPUS was conducted. The pooled estimate was acquired using correlation analysis between the diffusion tensor imaging parameters of fractional anisotropy and motor recovery based on the period of stroke onset. In the results, out of 511 retrieved articles, eight were finally included in the meta-analysis. In patients who underwent diffusion tensor imaging within 2 weeks of intracerebral hemorrhage onset, a random-effects model revealed that the ratio of fractional anisotropy is a significant predictor of motor recovery of the hemi-side extremity after intracerebral hemorrhage (p = 0.0015). In patients who underwent diffusion tensor imaging after 2 weeks of intracerebral hemorrhage onset, a fixed-effects model revealed that the ratio of fractional anisotropy was also a significant predictor of motor recovery of the hemi-side extremity after intracerebral hemorrhage (p < 0.0001). Our meta-analysis revealed that ratio of fractional anisotropy (rFa) calculated from diffusion tensor imaging (DTI) performed ≥2 weeks of intracerebral hemorrhage onset had a positive correlation with the motor outcomes after intracerebral hemorrhage (ICH). Also, although diffusion tensor imaging was performed <2 weeks after intracerebral hemorrhage onset, the ratio of fractional anisotropy calculated from diffusion tensor imaging helped predict the motor outcome. Further analyses, including a more significant number of studies focused on this topic, are warranted.