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

## TL;DR

A TCM therapy helped a TBI patient recover limb movement despite brain tract damage, suggesting alternative neural pathways may be involved.

## Contribution

Demonstrates motor recovery via non-CST pathways in TBI hemiplegia using meridian-sinew therapy and neuroimaging.

## Key findings

- Meridian-sinew therapy led to full muscle strength recovery despite incomplete corticospinal tract restoration.
- Neuroimaging showed compensatory networks may mediate motor recovery in traumatic brain injury patients.
- Structural integrity of the corticospinal tract did not fully recover, yet motor function improved significantly.

## Abstract

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.