弥散张量成像各向异性分数与缺血性脑卒中患者上肢运动功能的相关性

doi:10.3969/j.issn.1006-9771.2020.07.002

Abstract

Abstract:

Objective To explore the relationship between diffusion tensor imaging (DTI) parameter of fractional anisotropy (FA) and recovery of upper-extremity motor function in patients with ischemic stroke. Methods From January to December, 2019, 20 ischemic stroke patients accepted routine medication and rehabilitation for three weeks. They received DTI examination and were measured FA of the infarct and the corresponding area on the contralateral side, the cerebral foot and the posterior limb of internal capsule of affected and unaffected sides, while the bilateral FA ratio (rFA) of them were calculated, before and after treatment. Meanwhile, all the patients were assessed with Fugl-Meyer Assessment-Upper Extremity (FMA-UE). Results The FMA-UE score improved after treatment (t = 9.074, P < 0.001), while FA and rFA increased in infarct area ( t > 14.519, P< 0.001). The difference before and after treatment of FA and rFA in all of the areas positively correlated with that of FMA-UE scores (r = 0.445~0.565, P< 0.05), which was the most in posterior limb of internal capsule of the affected side.Conclusion FA of DTI alters with the recovery of motor function of the upper extremity after ischemic stroke, especially in the posterior limb of internal capsule.

Key words: ischemic stroke, motor function, upper limb, diffusion tensor imaging, rehabilitation

CLC Number:

R743.3

LIU Jian-hua,WEI Qing-chuan,HU Xiu-ru,YE Sai-qing,YAN Zhi-yu,GAO Qiang. Relationship between Fractional Anisotropy of Diffusion Tensor Imaging and Motor Function after Ischemic Stroke[J]. 《Chinese Journal of Rehabilitation Theory and Practice》, 2020, 26(7): 749-752.

Figures/Tables 2

References 22

[1]	Zhou M, Wang H, Zeng X, et al. Mortality, morbidity, and risk factors in China and its provinces, 1990-2017: a systematic analysis for the Global Burden of Disease Study 2017[J]. Lancet, 2019, 394(10204): 1145-1158. doi: 10.1016/S0140-6736(19)30427-1
[2]	Hankey G J. Stroke[J]. Lancet, 2017, 389(10069): 641-654. doi: 10.1016/S0140-6736(16)30962-X
[3]	Powers W J, Rabinstein A A, Ackerson T, et al. 2018 Guidelines for the Early Management of Patients with Acute Ischemic Stroke: a guideline for healthcare professionals from the American Heart Association/American Stroke Association[J]. Stroke, 2018, 49(3): e46-e110.
[4]	Lindenberg R, Renga V, Zhu L L, et al. Structural integrity of corticospinal motor fibers predicts motor impairment in chronic stroke[J]. Neurology, 2010, 74(4): 280-287. doi: 10.1212/WNL.0b013e3181ccc6d9 pmid: 20101033
[5]	Lope-Piedrafita S. Diffusion tensor imaging (DTI)[J]. Methods Mol Biol, 2018, 1718:103-116. doi: 10.1007/978-1-4939-7531-0_7 pmid: 29341005
[6]	Welniarz Q, Dusart I, Roze E. The corticospinal tract: evolution, development, and human disorders[J]. Dev Neurobiol, 2017, 77(7): 810-829. doi: 10.1002/dneu.22455 pmid: 27706924
[7]	Jang S H. The corticospinal tract from the viewpoint of brain rehabilitation[J]. J Rehabil Med, 2014, 46(3): 193-199. doi: 10.2340/16501977-1782
[8]	陈丹凤, 燕铁斌, 黎冠东, 等. 磁共振弥散张量成像参数与脑卒中早期患者下肢运动功能恢复的相关性研究[J]. 中国康复医学杂志, 2018, 33(7): 812-816.
	Chen D F, Yan T B, Li G D, et al. Predictive study of magnetic resonance diffusion tensor imaging in the rehabilitation of lower limb in patients with early stage stroke[J]. Chin J Rehabil Med, 2018, 33(7): 812-816
[9]	黄东锋, 李乐, 毛玉瑢, 等. 脑卒中后神经网络损害与下肢步行功能结局的关系[J]. 中国康复医学杂志, 2012, 27(9): 787-791.
	Huang D F, Li L, Mao Y R, et al. The relationship between neural network damage and the gait function in lower limbs in patients post-stroke[J]. Chin J Rehabil Med, 2012, 27(9): 787-791.
[10]	赖喜新, 倪莹莹, 赵春梅, 等. 脑卒中患者磁共振弥散张量成像检查皮质脊髓束与下肢肌力恢复的关系[J]. 中华老年心脑血管病杂志, 2014, 16(4): 395-397.
	Lai X X, Ni Y Y, Zhao C M, et al. Role of DTI in demonstrating the relation between lateral CST repair and lower limb muscle strength recovery in IS patients[J]. Chin J Geriatr Heart Brain Vessel Dis, 2014, 16(4): 395-397.
[11]	Le Bihan D, Mangin J, Poupon C, et al. Diffusion tensor imaging: concepts and applications[J]. J Magn Reson Imaging, 2001, 13(4): 534-546. pmid: 11276097
[12]	Park C H, Kou N, Boudrias M H, et al. Assessing a standardised approach to measuring corticospinal integrity after stroke with DTI[J]. Neuroimage Clin, 2013, 2(5): 21-33.
[13]	Koyama T, Marumoto K, Miyake H, et al. Relationship between diffusion tensor fractional anisotropy and motor outcome in patients with hemiparesis after corona radiata infarct[J]. J Stroke Cerebrovasc Dis, 2013, 22(8): 1355-1360. doi: 10.1016/j.jstrokecerebrovasdis.2013.02.017
[14]	谢运娟, 廖伶艺, 高强. 弥散张量成像在脑卒中患者运动功能预后评估中的研究进展[J]. 中国康复理论与实践, 2019, 25(5): 546-549.
	Xie Y J, Liao L Y, Gao Q. Advance in diffusion tensor imaging for predicting motor function outcome after stroke[J]. Chin J Rehabil Theory Pract, 2019, 25(5): 546-549.
[15]	王旭, 刘斌, 杨明, 等. 扩散张量成像与急性脑干缺血性卒中患者运动功能预后的相关性[J]. 中国医学影像学杂志, 2014, 23(4): 255-259.
	Wang X, Liu B, Yang M, et al. Diffusion tensor imaging in predicting the motor function of patients with acute ischaemic stroke in the brainstem[J]. Chin J Med Imag, 2014, 23(4): 255-259.
[16]	Wang R R, Li C, Zhang S, et al. Diffusion tensor imaging change in crus cerebri in striatocapsular infarction and correlation with upper extremity motor dysfunction[J]. Radiol Med, 2015, 120(11): 1064-1070. doi: 10.1007/s11547-015-0534-0
[17]	Kwak S Y, Yeo S S, Choi B Y, et al. Corticospinal tract change in the unaffected hemisphere at the early stage of intracerebral hemorrhage: a diffusion tensor tractography study[J]. Eur Neurol, 2010, 63(3): 149-153. doi: 10.1159/000281108
[18]	Fan Y T, Lin K C, Liu H L, et al. Changes in structural integrity are correlated with motor and functional recovery after post-stroke rehabilitation[J]. Restor Neurol Neurosci, 2015, 33(6): 835-844.
[19]	Puig J, Blasco G, Schlaug G, et al. Diffusion tensor imaging as a prognostic biomarker for motor recovery and rehabilitation after stroke[J]. Neuroradiology, 2017, 59(4): 343-351. doi: 10.1007/s00234-017-1816-0
[20]	Thomalla G, Glauche V, Koch M A, et al. Diffusion tensor imaging detects early Wallerian degeneration of the pyramidal tract after ischemic stroke[J]. Neuroimage, 2004, 22(4): 1767-1774. pmid: 15275932
[21]	Puig J, Pedraza S, Blasco G, et al. Wallerian degeneration in the corticospinal tract evaluated by diffusion tensor imaging correlates with motor deficit 30 days after middle cerebral artery ischemic stroke[J]. Am J Neuroradiol, 2010, 31(7): 1324-1330. doi: 10.3174/ajnr.A2038
[22]	凌晴, 林丽萍, 胡世红, 等. 脑卒中后上肢运动功能恢复大脑可塑性的磁共振弥散张量成像研究[J]. 中国康复理论与实践, 2015, 21(9): 1058-1063.
	Ling Q, Lin L P, Hu S H, et al. Brain plasticity of upper extremity motor function recovery after stroke: a diffusion tensor imaging study[J]. Chin J Rehabil Theory Pract, 2015, 21(9): 1058-1063.

项目		治疗前	治疗后	t值	P值
FMA-UE		28.25±7.15	34.75±7.21	9.074	< 0.001
患侧FA	梗死灶	0.546±0.071	0.612±0.072	14.519	< 0.001
	内囊后肢	0.578±0.154	0.594±0.161	2.087	0.051
	大脑脚	0.646±0.139	0.661±0.153	1.976	0.063
rFA	梗死灶	0.616±0.084	0.691±0.084	14.858	< 0.001
	内囊后肢	0.652±0.171	0.670±0.178	2.058	0.054
	大脑脚	0.730±0.160	0.748±0.176	2.028	0.057

项目		差值	r值	P值
FMA-UE		6.500±3.204
患侧FA	梗死灶	0.067±0.021	0.492	0.028
	内囊后肢	0.016±0.035	0.564	0.001
	大脑脚	0.015±0.035	0.445	0.049
rFA	梗死灶	0.075±0.023	0.448	0.047
	内囊后肢	0.019±0.040	0.565	< 0.001
	大脑脚	0.018±0.039	0.503	0.024

Relationship between Fractional Anisotropy of Diffusion Tensor Imaging and Motor Function after Ischemic Stroke

RichHTML

PDF (PC)

Knowledge

Abstract

Cite this article

share this article

Figures/Tables 2

References 22

Related Articles 15

Metrics

Comments

Recommended 0

[1]	LUO Lihua, WANG Yusheng, LI Jianfeng, DONG Jige. Effect of early postoperative comprehensive rehabilitation on children and youth with supracondylar fracture of humerus complicated with ulnar nerve injury [J]. 《Chinese Journal of Rehabilitation Theory and Practice》, 2024, 30(1): 105-110.
[2]	WANG Zihao, LI Xinhua, JIANG Huiping, GUO Sainan, LIANG Qiuman, SHI Tingqi. Short-term knee function after total knee arthroplasty and related factors [J]. 《Chinese Journal of Rehabilitation Theory and Practice》, 2024, 30(1): 111-118.
[3]	LIN Na, GAO Hanlu, LU Huiping, CHEN Yanqing, ZHENG Junfan, CHEN Shurong. Effect of virtual reality on upper limb function after stroke: a study of diffusion tensor imaging [J]. 《Chinese Journal of Rehabilitation Theory and Practice》, 2024, 30(1): 61-67.
[4]	CHEN Junwen, CHEN Qian, CHEN Cheng, LI Shuyue, LIU Lingling, WU Cunshu, GONG Xiang, LU Jun, XU Guangxu. Effect of modified Baduanjin exercise on cardiopulmonary function, motor function and activities of daily living for stroke patients [J]. 《Chinese Journal of Rehabilitation Theory and Practice》, 2024, 30(1): 74-80.
[5]	SHI Jiawei, LI Lingyu, YANG Haojie, WANG Qinlu, ZOU Haiou. Effect of preoperative prerehabilitation training on total knee arthroplasty: a systematic review of systematic reviews [J]. 《Chinese Journal of Rehabilitation Theory and Practice》, 2023, 29(9): 1057-1064.
[6]	CAI Huanian, FEI Sixian, ZHANG Yichen, SUN Qing, GUO Shuai, SONG Tao. Motion assistance analysis for robot-assisted tele-rehabilitation based on bilateral admittance control [J]. 《Chinese Journal of Rehabilitation Theory and Practice》, 2023, 29(9): 1104-1109.
[7]	SUN Tengfang, REN Mengting, YANG Lin, WANG Yaoting, WANG Hongyu, YAN Xingzhou. Effect of hyperbaric oxygen therapy combined with repetitive peripheral magnetic stimulation on ankle motor function and balance of stroke patients [J]. 《Chinese Journal of Rehabilitation Theory and Practice》, 2023, 29(8): 875-881.
[8]	WANG Ya'nan, LIU Xihua. Correlation and predictive effect of subjective and objective balance function measurements in stroke patients with hemiplegia [J]. 《Chinese Journal of Rehabilitation Theory and Practice》, 2023, 29(8): 890-895.
[9]	WANG Haiyun, WANG Yin, ZHOU Xinjie, HE Aiqun. Effect of transcranial direct current stimulation combined with acupuncture on central and upper limb function in stroke patients based on central-peripheral-central theory [J]. 《Chinese Journal of Rehabilitation Theory and Practice》, 2023, 29(8): 919-925.
[10]	CHEN Yiting, WANG Qian, CUI Shenhong, LI Yingcai, ZHANG Siyu, WEI Yanxu, REN Hui, LENG Jun, CHEN Bin. Effect of bilateral sequential repetitive transcranial magnetic stimulation on motor function of upper limbs in stroke patients [J]. 《Chinese Journal of Rehabilitation Theory and Practice》, 2023, 29(8): 926-932.
[11]	LIU Yang, ZHANG Peng, HUANG Ying, CHEN Han, XU Chen, LI Min. Path analysis of mediating effect of perceived stress affecting impact of event in rehabilitation patients with traumatic injury [J]. 《Chinese Journal of Rehabilitation Theory and Practice》, 2023, 29(8): 954-960.
[12]	YI Qifeng, HUANG Zhuoer, YANG Guoli, XIE Lihua, XIE Shengfeng, WU Xiaoxia, YAN Jin. Development, and reliability and validity testing of a knowledge needs questionnaire of respiratory rehabilitation training for in-service healthcare workers [J]. 《Chinese Journal of Rehabilitation Theory and Practice》, 2023, 29(8): 985-992.
[13]	LI Ziyi, SONG Weiqun, DU Jubao, CAO Guanglei, ZHANG Yanming, LI Ran. Effect of motor imagery on knee function after unicompartmental knee arthroplasty [J]. 《Chinese Journal of Rehabilitation Theory and Practice》, 2023, 29(7): 745-749.
[14]	REN Yi, WANG Rui, ZHANG Yaohua. Effect of proprioceptive neuromuscular facilitation combined with neuromuscular electrical stimulation on chronic ankle instability [J]. 《Chinese Journal of Rehabilitation Theory and Practice》, 2023, 29(7): 750-755.
[15]	LI Fang, HUO Su, DU Jubao, LIU Xiuzhen, LI Xiaoshuang, SONG Weiqun. Effect of transcranial direct current stimulation combined with task-oriented rehabilitation training on forelimb motor dysfunction in rats with spinal cord injury [J]. 《Chinese Journal of Rehabilitation Theory and Practice》, 2023, 29(7): 777-781.