Objective: This study aimed to investigate whether initial corticospinal tract (CST) integrity and clinical assessments are associated with motor recovery after stroke and whether follow-up CST evaluation provides additional explanatory value for predicting outcomes.
Methods: Eighty patients with stroke underwent diffusion tensor tractography (DTT) during the subacute and chronic phases. Motor recovery at 6 months was assessed using the Fugl-Meyer Assessment (FMA). Baseline CST integrity was quantified using the fiber-number ratio (FNr). Multivariable regression analyses were conducted to determine the explanatory contributions of baseline and follow-up CST integrity. Among patients with severe motor impairment (initial FMA-upper score <20), motor outcomes were compared between the preserved and disrupted CST groups.
Results: Initial FNr, FMA scores, and muscle strength were independently associated with motor recovery. The inclusion of follow-up CST integrity did not significantly increase the proportion of explained variance in motor outcomes. Among patients with severe impairment, those with preserved CST integrity exhibited significantly higher FMA total scores.
Conclusions: Initial CST integrity and clinical factors were independently associated with motor recovery, whereas follow-up DTT did not provide significant additional explanatory value. Early assessments may inform prognostic evaluation and guide rehabilitation planning, even in patients with severe stroke.
Significance: Early CST integrity is independently associated with motor recovery, supporting its potential as a prognostic biomarker in stroke rehabilitation.
Objective: While cortico-cortical spectral responses (CCSRs) have shown potential for seizure onset zone (SOZ) localization, it is unclear which features of the CCSR are most localizing, limiting their use as potential biomarkers of the SOZ.
Methods: Single-pulse electrical stimulation (SPES) was performed during intracranial EEG (sEEG and ECoG) monitoring in 27 patients, and CCSRs were calculated. We quantified significant increases and decreases in the CCSR and then segmented the CCSRs into 11 time-frequency zones (TFZs). We compared brain regions with the most significant responses in each TFZ to the hypothesized SOZ to determine the localization potential of individual TFZs.
Results: We found that the contacts having the strongest responses in the TFZ spanning the high gamma frequency band (50-250 Hz) and the N2 time interval (50-500 ms) were more related to the SOZ than other TFZs.
Conclusions: These findings suggest that changes in high gamma power 50-500 ms following SPES hold the greatest SOZ localizing potential and may be optimal parameters for investigating the CCSR for biomarkers of the SOZ.
Significance: Optimal interpretation of CCSRs may lead to improved SOZ localization and more favorable treatment outcomes for those with drug-resistant epilepsy.

