Diffusion Tensor Fractional Anisotropy in the Superior Longitudinal Fasciculus Correlates with Functional Independence Measure Cognition Scores in Patients with Cerebral Infarction
Diffusion Tensor Fractional Anisotropy in the Superior Longitudinal Fasciculus Correlates with Functional Independence Measure Cognition Scores in Patients with Cerebral Infarction
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DOI：
10.1016/j.jstrokecerebrovasdis.2017.03.034
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发表时间：
2017-08-01
影响因子：
2.5
通讯作者：
Domen, Kazuhisa
中科院分区：
文献类型：
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作者：
Koyama, Tetsuo;Domen, Kazuhisa
背景：本研究旨在确定弥散张量成像(DTI)测量的纤维束退行性变与脑梗塞患者预后的关系。方法：首次心肌梗死患者于发病后14~21d行DTI成像，绘制分数各向异性(FA)图，并用基于区域的空间统计方法(TBSS)进行分析。皮质脊髓束(CST)和上纵束(SLF)内的平均FA值是从个体TBSS数据中提取的。用Spearman‘s等级相关检验检验FA比率与Brunnstrom分级(BRS)和功能独立性测量(FIM)运动和认知评分之间的关系。结果：40例患者(左半球病变21例，右半球病变19例)进入分析数据库。肩、肘、前臂BRS为1~6(中位数，5)，手、手指为2~6(中位数，4.5)，小腿为3~6(中位数，5)。FIM运动范围51~91(中位数79.5)，FIM认知范围16~35(中位数29)。CST的RFA值从.692到1.053(中位数，0.933)，SLF的RFA值从.778到1.076(中位数，.965)。Mann-Whitney U检验(P<；0.05)显示左侧和右侧大脑半球病变组之间无显著差异。CST的个体RFA值与BRS得分相关(r=.585-0.654)，而SLF的个体RFA值与FIM认知得分相关(r=.409，P<；0.05)。结论：SLF和CST的DTI-FA值分别可用于预测认知功能和肢体功能的预后。(三)2017年全国卒中协会。爱思唯尔公司出版，版权所有。
Background: This study aimed to determine the relationship between fiber tract degeneration measured by diffusion-tensor imaging (DTI) and outcome of patients after cerebral infarction. Methods: Fractional anisotropy (FA) maps were generated by DTI in patients 14-21 days after the first infarction and were analyzed by tract-based spatial statistics (TBSS). Mean FA values within the corticospinal tract (CST) and the superior longitudinal fasciculus (SLF) were extracted from individual TBSS data. Relationships between FA ratios (rFAs, lesioned to non-lesioned hemisphere) and outcomes assessed by Brunnstrom stage (BRS) and Functional Independence Measure (FIM) motor and cognition scores were examined using Spearman's rank correlation test. Results: Forty patients (21 left and 19 right hemisphere lesions) were entered into an analytical database. BRS ranged from 1 to 6 (median, 5) for shoulder, elbow, or forearm; from 2 to 6 (median, 4.5) for hand or finger; and from 3 to 6 (median, 5) for lower extremity. FIM motor ranged from 51 to 91 (median, 79.5), and FIM cognition ranged from 16 to 35 (median, 29). rFA values in the CST ranged from .692 to 1.053 (median,.933), and those in the SLF ranged from .778 to 1.076 (median, .965). Mann-Whitney U test (P < .05) revealed no significant differences between the left and the right hemisphere lesion groups. Individual rFA values in the CST correlated with BRS scores (r = .585-0.654), whereas those in the SLF correlated with FIM cognition scores (r = .409, P < .05). Conclusions: DTI-FA values in the SLF and CST may be useful for outcome prediction of cognitive function and extremity function, respectively. (C) 2017 National Stroke Association. Published by Elsevier Inc. All rights reserved.