Motor Recovery Prediction With Clinical Assessment and Local Diffusion Homogeneity After Acute Subcortical Infarction
Motor Recovery Prediction With Clinical Assessment and Local Diffusion Homogeneity After Acute Subcortical Infarction
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急性皮质下梗塞后的运动恢复预测与临床评估和局部扩散均匀性
DOI：
10.1161/strokeaha.117.017060
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发表时间：
2017-08-01
期刊：
影响因子：
8.3
通讯作者：
Zeng, Jinsheng
中科院分区：
文献类型：
--
作者：
Liu, Gang;Tan, Shuangquan;Zeng, Jinsheng
背景和目的：最初的临床评估或常规的扩散张量成像参数本身并不能可靠地预测卒中后运动功能的恢复。最近，局部扩散均匀度(LDH)被提出用来表示水分子扩散的局部相干性，可以作为研究大脑白质改变的补充标志。我们的目的是确定初始临床评估和LDH相结合是否可以预测急性皮质下梗塞后运动功能的恢复。方法：对50例皮质下梗塞患者在发病1、4和12周后进行标准上肢Fugl-Meyer评估和扩散张量成像。采用比例恢复模型残差将患者分为比例恢复组和差恢复组。基于区域的空间统计分析被用来比较比例恢复和较差恢复结果之间的扩散差异。结果：卒中后1周，恢复不良组LDH低于比例恢复组，主要集中在上冠辐射皮质脊髓束和内囊后肢，差异有统计学意义(P
Background and Purpose-Initial clinical assessment or conventional diffusion tensor imaging parameters alone do not reliably predict poststroke recovery of motor function. Recently, local diffusion homogeneity (LDH) has been proposed to represent the local coherence of water molecule diffusion and can serve as a complementary marker for investigating white matter alterations of the brain. We aimed to determine whether a combination of initial clinical assessment and LDH could predict motor recovery after acute subcortical infarction.Methods-Standard upper extremity Fugl-Meyer assessment and diffusion tensor imaging were performed 1, 4, and 12 weeks after onset in 50 patients with subcortical infarction. Proportional recovery model residuals were used to assign patients to proportional recovery and poor recovery groups. Tract-based spatial statistics analysis was used to compare diffusion differences between proportional and poor recovery outcomes. Multivariate logistic regression model was used to identify the predictors of motor improvement within 12 weeks after stroke.Results-The poor recovery group had lower LDH than the proportional recovery group, mainly in the ipsilesional corticospinal tract in the superior corona radiate and posterior limb of internal capsule 1 week after stroke (P