Structural-Functional Dissociation in TBI Hemiplegia: Meridian-Sinew Therapy Promotes Motor Recovery Despite Corticospinal Tract Damage-A Case Report.

This study presents neuroimaging analysis of a 31-year-old male patient with hemiplegia secondary to severe traumatic brain injury who was treated with an external therapy of Traditional Chinese Medicine (TCM) called meridian-sinew therapy. The patient exhibited complete right-sided limb paralysis following trauma, with full muscle strength recovery after therapy. Serial diffusion tensor imaging evaluations revealed persistently reduced fractional anisotropy values in the left corticospinal tract (CST.L) below the normal range posttreatment, indicating a structure-function decoupling phenomenon. Despite incomplete restoration of structural integrity in CST.L, significant motor function improvement was observed. The findings suggest that meridian-sinew therapy may promote motor recovery through activation of compensatory networks involving non-CST pathways. This investigation provides neuroimaging evidence supporting the therapeutic efficacy of meridian-sinew therapy in TBI-induced hemiplegia and offers novel insights into potential mechanisms of action.