Atrophy of spared gray matter tissue predicts poorer motor recovery and rehabilitation response in chronic stroke.
Atrophy of spared gray matter tissue predicts poorer motor recovery and rehabilitation response in chronic stroke.
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DOI：
10.1161/strokeaha.111.633255
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发表时间：
2012-02
期刊：
影响因子：
8.3
通讯作者：
Uswatte G
中科院分区：
文献类型：
--
作者：
Gauthier LV;Taub E;Mark VW;Barghi A;Uswatte G
尽管中风后的运动障碍显然是由于结构性脑损伤造成的，但这种关系从急性到慢性阶段逐渐减弱。我们调查了慢性中风患者的运动损伤和对强制诱导运动疗法(CI疗法)的反应可能与远离病变的脑结构的结构完整性更密切相关，而不是与公开的组织损伤措施有关。对80例慢性卒中患者的MRI扫描进行了体素形态计量(VBM)分析，以探讨灰质密度的变化是否与残存运动障碍的程度或脑梗塞治疗诱导的运动恢复有关。非梗死运动区灰质密度的降低与残留运动缺陷的程度显著相关。此外，多个偏远脑区灰质密度的降低预示着CI治疗对运动改善的程度较小。在慢性中风的持续性运动障碍中，远离梗塞的看似健康的大脑部分出现萎缩，这至少是一部分原因。
Although the motor deficit following stroke is clearly due to the structural brain damage that has been sustained, this relationship is attenuated from the acute to chronic phases. We investigated the possibility that motor impairment and response to Constraint-Induced Movement therapy (CI therapy) in chronic stroke patients may relate more strongly to the structural integrity of brain structures remote from the lesion than to measures of overt tissue damage. Voxel-based morphometry (VBM) analysis was performed on MRI scans from 80 chronic stroke patients to investigate whether variations in grey matter density were correlated with extent of residual motor impairment or with CI therapy-induced motor recovery. Decreased grey matter density in non-infarcted motor regions was significantly correlated with magnitude of residual motor deficit. In addition, reduced grey matter density in multiple remote brain regions predicted a lesser extent of motor improvement from CI therapy. Atrophy in seemingly healthy parts of the brain that are distant from the infarct accounts for at least a portion of the sustained motor deficit in chronic stroke.