Behavioural clusters and predictors of performance during recovery from stroke
Behavioural clusters and predictors of performance during recovery from stroke
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DOI：
10.1038/s41562-016-0038
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发表时间：
2017-03-01
影响因子：
29.9
通讯作者：
Corbetta, M.
中科院分区：
文献类型：
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作者：
Ramsey, L. E.;Siegel, J. S.;Corbetta, M.
我们在多个行为领域研究了中风后恢复的模式和变异性。在卒中后1 - 2周、3个月和1年，采用结构性磁共振成像测量病变解剖结构和44项神经心理学测试评估行为结局，前瞻性和纵向研究了一个大队列的异质性病变首次卒中患者。在所有时间点，通过几组相关缺陷来描述损害。恢复的时间过程和幅度在行为领域是相似的，变化分数在很大程度上与初始赤字成比例，大多数恢复发生在前三个月内。特定白色束的损伤导致以下几个领域的恢复较差：注意力（上级纵束II/III）、语言（后弓状束）和运动（皮质脊髓束）。最后，在考虑了初始缺陷的严重程度后，语言和视觉记忆恢复对于那些教育水平较低的人来说更差，而多重缺陷的发生对注意力恢复产生了负面影响。
We examined the patterns and variability of post-stroke recovery in multiple behavioural domains. A large cohort of first-time stroke patients with heterogeneous lesions was studied prospectively and longitudinally at one to two weeks, three months and one year after the stroke using structural magnetic resonance imaging to measure lesion anatomy and 44 neuropsychological tests to assess behavioural outcomes. Impairment was described at all time points by a few clusters of correlated deficits. The time course and magnitude of recovery was similar across behavioural domains, with change scores largely proportional to the initial deficit and most recovery occurring within the first three months. Damage to specific white matter tracts produced poorer recovery for several domains: attention (superior longitudinal fasciculus II/III), language (posterior arcuate fasciculus) and motor (corticospinal tract). Finally, after accounting for the severity of the initial deficit, language and visual memory recovery was worse for those with lower levels of education, while the occurrence of multiple deficits negatively impacted attention recovery.