基于弥散张量纤维束成像探讨皮质脊髓束损伤对脑卒中运动功能障碍的评估价值

doi:10.3969/j.issn.1006-9771.2018.12.015

Abstract

Abstract: Objective To investigate the relationship between disrupted corticospinal tract (CST) and motor recovery after stroke by using diffusion tensor tracking (DTT). Methods From March, 2012 to June, 2013, 15 chronic stroke patients with left subcortical lesions and 15 age- and sex- matched healthy subjects were performed diffusion tensor imaging (DTI) examination. The CST was tracked by DTT technique, and the damaged values of the CST caused by the stroke lesions were quantified using a CST template generated from healthy controls. Furthermore, the correlations of the damaged values of the CST with Fugl-Meyer Assessment (FMA) were performed. Results The range of the damaged values of CST in stroke patients was 0.00% to 29.6%. There were very strong negative correlation between the damaged values of the CST and FMA scores (the wrist, r = -0.660; hand, r = -0.813; wrist plus hand, r = -0.795, respectively, P < 0.01). It also showed strong negative correlation between the damaged values of the CST and FMA scores (upper limb, r = -0.614; upper limb plus lower limb, r = -0.563, respectively, P < 0.05). Whereas, there was no correlation between the damaged values of the CST and FMA scores of lower limb (r = -0.270, P = 0.331). In addition, the lesion volumes of stroke and FMA scores were not significantly correlated (P > 0.05). Conclusion The severity of motor deficit after stroke was closely related to the overlap of lesions with CST. The damaged values of the CST based on DTT may be used as a potential biomarker to assess motor impairments of upper limbs, especially hand and wrist in stroke patients.

Key words: stroke, diffusion tensor imaging, corticospinal tract, hand, upper extremity, dysfunction

CLC Number:

R743.3

GAO Xin-jie, TANG Chao-zheng, XU Guo-jun, YU Qiu-rong, YANG Hao, JIA Jie, SUN Li-min, YIN Da-zhi, FAN Ming-xia. Assessment Value of Disrupted Corticospinal Tract Secondary to Stroke Lesion for Motor Impairment: A Diffusion Tensor Tracking Study[J]. 《Chinese Journal of Rehabilitation Theory and Practice》, 2018, 24(12): 1432-1437.

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Assessment Value of Disrupted Corticospinal Tract Secondary to Stroke Lesion for Motor Impairment: A Diffusion Tensor Tracking Study

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