Microstructural status of ipsilesional and contralesional corticospinal tract correlates with motor skill in chronic stroke patients.
Microstructural status of ipsilesional and contralesional corticospinal tract correlates with motor skill in chronic stroke patients.
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DOI：
10.1002/hbm.20770
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发表时间：
2009-11
影响因子：
4.8
通讯作者：
Makris, Nikos
中科院分区：
文献类型：
--
作者：
Schaechter, Judith D.;Fricker, Zachary P.;Perdue, Katherine L.;Helmer, Karl G.;Vangel, Mark G.;Greve, Douglas N.;Makris, Nikos
脑卒中偏瘫患者同侧皮质脊髓束（CST）结构完整性的较大损失与运动预后较差相关。中风的动物模型已经证明，同侧和对侧半球中白色物质的结构重塑与运动恢复的改善相关。因此，中风患者的运动恢复可能与CST变性和重塑的相对强度有关。本研究探讨了脑白色物质束的显微结构状态之间的关系，指数的分数各向异性（FA）度量来自扩散张量成像（DTI）数据，和运动技能的中风影响的手在慢性中风患者。体素分析显示，运动技能与病灶同侧和对侧CST的FA呈显著正相关。额外的voxelwise分析表明，运动技能较差的患者减少FA的双边CST相比，正常对照组，而运动技能较好的患者升高FA的双边CST相比，对照组。这些发现证实了使用DTI纤维束成像方法适用于CST在两个半球。本研究的结果表明，偏瘫脑卒中患者的运动技能恢复水平与同侧和对侧大脑半球CST的微结构状态有关，这可能反映了双侧CST变性和重塑的净效应。
Greater loss in structural integrity of the ipsilesional corticospinal tract (CST) is associated with poorer motor outcome in hemiparetic stroke patients. Animal models of stroke have demonstrated that structural remodeling of white matter in the ipsilesional and contralesional hemispheres is associated with improved motor recovery. Accordingly, motor recovery in stroke patients may relate to the relative strength of CST degeneration and remodeling. This study examined the relationship between microstructural status of brain white matter tracts, indexed by the fractional anisotropy (FA) metric derived from diffusion tensor imaging (DTI) data, and motor skill of the stroke-affected hand in chronic stroke patients. Voxelwise analysis revealed that motor skill significantly and positively correlated with FA of the ipsilesional and contralesional CST in the patients. Additional voxelwise analyses showed that patients with poorer motor skill had reduced FA of bilateral CST compared to normal control subjects whereas patients with better motor skill had elevated FA of bilateral CST compared to controls. These findings were confirmed using a DTI-tractography method applied to the CST in both hemispheres. The results of this study suggest that the level of motor skill recovery achieved in hemiparetic stroke patients relates to microstructural status of the CST in both the ipsilesional and contralesional hemispheres, which may reflect the net effect of degeneration and remodeling of bilateral CST.
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