Establishing the reproducibility of two approaches to quantify white matter tract integrity in stroke.
Establishing the reproducibility of two approaches to quantify white matter tract integrity in stroke.
复制标题
DOI：
10.1016/j.neuroimage.2011.09.009
复制
发表时间：
2012-02-01
期刊：
影响因子：
5.7
通讯作者：
Boyd, Lara A.
中科院分区：
文献类型：
--
作者：
Borich, Michael R.;Wadden, Katie P.;Boyd, Lara A.
弥散张量成像可以提供有关中风后白质解剖结构的独特而详细的信息。使用基于束的技术进行纤维束重建和感兴趣横截面区域划分是量化白质完整性的两种常见方法。中风后，白质束的完整性可能会受到局部和远端原发病变位置的影响。研究表明，纤维束破坏与中风患者的功能损伤程度和对技能训练的反应有关。然而，这些方法的可靠性和有效性尚未得到系统评估，也没有在慢性卒中个体中直接比较这两种方法。研究人员对 10 名康复良好的皮质下慢性右侧缺血性中风患者和 10 名年龄、性别和惯用手习惯相匹配的健康参与者进行了研究。双侧进行同侧和对侧皮质脊髓束的半自动纤维束成像以及内囊后肢的感兴趣横截面区域绘制。各向异性分数 (FA) 值和 FA 中的半球不对称性是管道完整性的主要衡量标准。两名评估者对每种分析方法执行两次，以评估评估者间和评估者内部的可靠性。将中风参与者与健康个体进行比较，以确定每种分析方法的有效性。进行相关分析以检查两种方法之间的关系以及方法与上肢运动障碍之间的关联。两种分析方法在每组中均表现出良好至优异的评估者内和评估者间可靠性（p<0.05）。与健康个体相比，中风参与者在同侧和对侧束的完整性方面表现出较低的平均 FA 值，以及较大的 FA 半球不对称性（p<0.05）。分析方法之间的比较揭示了两组之间以及每组内的方法之间存在显着关联（p<0.05）。在卒中中，同侧（r = 0.26）或对侧（0.15）束入路之间的个体束完整性不相关，FA半球不对称性（r = 0.18）也不相关。此外，用横断面方法量化的对侧平均 FA 与上肢运动障碍相关（r=0.69）。重要的是，这项研究首次系统地描述了在康复良好的慢性中风患者和匹配的健康参与者中基于纤维束和横截面 DTI 分析方法的可靠性。结果表明，评估白质束完整性的基于束的方法和横截面方法都是可靠的，可以区分中风组和健康参与者，并且彼此相关。然而，只有使用横断面方法得出的对侧平均 FA 值与上肢损伤相关。我们的研究结果表明，每种方法都提供了关于完整性的补充而非冗余信息，并支持在未来对康复良好的中风患者的研究中结合使用这两种方法。
Diffusion tensor imaging can provide unique and detailed information about white matter anatomy following stroke. Fiber tract reconstruction using tract-based techniques and cross-sectional region of interest delineation are two common approaches to quantify white matter integrity. After stroke, white matter tract integrity can be affected both locally and distally to the primary lesion location. It has been shown that tract disruption is associated with degree of functional impairment and response to skill training in participants with stroke. However, the reliability and validity of these approaches has not been systematically evaluated nor have the two approaches been directly compared in individuals with chronic stroke. Ten well-recovered individuals with chronic, right-sided, ischemic stroke in the sub-cortex and ten age-, gender- and handedness-matched healthy participants were studied. Semi-automated tractography of the ipsi- and contralesional corticospinal tract and cross-sectional region of interest drawing of the posterior limb of the internal capsule were performed bilaterally. Fractional anisotropy (FA) values and the hemispheric asymmetry in FA were the primary measures of tract integrity. Two raters performed each analysis method twice to evaluate inter- and intra-rater reliability. Participants with stroke were compared to healthy individuals to determine validity of each analysis approach. Correlational analyses were conducted to examine the relationships between the two approaches and the association between approaches and upper extremity motor impairment. Both analyses methods generally demonstrated good to excellent intra- and inter-rater reliability in each group (p<0.05). Stroke participants demonstrated lower mean FA values in both ipsi- and contralesional tract integrity, and larger FA hemispheric asymmetry as compared with healthy individuals (p<0.05). Comparison between the analysis approaches revealed significant associations between approaches across both groups and within each group (p<0.05). In stroke, individual tract integrity was not correlated between approaches for ipsilesional (r=0.26) or contralesional (0.15) tracts, nor was FA hemispheric asymmetry (r=0.18). Additionally, contralesional mean FA quantified with the cross-sectional approach correlated with upper extremity motor impairment (r=0.69). Importantly, this study is the first to systematically characterize the reliability of tract-based and cross-sectional DTI analysis approaches in well-recovered individuals with chronic stroke and matched healthy participants. Results suggest both tract-based and cross-sectional approaches to evaluate white matter tract integrity are reliable, can differentiate between groups of stroke and healthy participants, and are associated with one another. However, only mean FA values for the contralesional side derived using the cross-sectional approach were related to upper extremity impairment. Our findings suggest that each approach provides complimentary rather than redundant information regarding integrity and support the use of both approaches in combination in future investigations in well-recovered individuals with stroke.
登录
查看更多内容
影响因子：
4.8
作者：
Schaechter, Judith D.;Fricker, Zachary P.;Perdue, Katherine L.;Helmer, Karl G.;Vangel, Mark G.;Greve, Douglas N.;Makris, Nikos
通讯作者：
Makris, Nikos
影响因子：
4.4
作者：
Farrell, Jonathan A. D.;Landman, Bennett A.;Mori, Susumu
通讯作者：
Mori, Susumu
影响因子：
6.3
作者：
Buffon, F;Molko, N;Chabriat, H
通讯作者：
Chabriat, H
影响因子：
2.5
作者：
Kimberley, Teresa Jacobson;Borich, Michael R.;Poepping, Joseph M.
通讯作者：
Poepping, Joseph M.
影响因子：
--
作者：
Nowak, Dennis A.;Grefkes, Christian;Fink, Gereon R.
通讯作者：
Fink, Gereon R.