Prediction of Upper Limb Motor Recovery after Subacute Ischemic Stroke Using Diffusion Tensor Imaging: A Systematic Review and Meta-Analysis.
Prediction of Upper Limb Motor Recovery after Subacute Ischemic Stroke Using Diffusion Tensor Imaging: A Systematic Review and Meta-Analysis.
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DOI：
10.5853/jos.2015.01186
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发表时间：
2016-01
影响因子：
8.2
通讯作者：
Prasad K
中科院分区：
文献类型：
--
作者：
Kumar P;Kathuria P;Nair P;Prasad K
使用扩散张量成像（DTI）早期评估锥体束是决定最佳治疗或评估适当康复的先决条件。DTI对缺血性卒中（IS）运动和功能恢复的早期预测价值产生了相互矛盾的结果。目的是系统地回顾和总结目前可用的文献的各向异性分数（FA）参数的DTI预测亚急性IS后上肢运动恢复的价值。对MEDLINE、PubMed、EMBASE、Google Scholar和科克伦CENTRAL进行了检索，检索时间为1950年1月1日至2015年7月31日，并补充了参考文献中识别的相关文章。将FA与上肢运动功能恢复指标进行相关性分析。使用Higgins I-squared、Tau-squared检查异质性。使用随机效应模型确定相关系数总结。在166篇引文中，只有11项研究符合系统性综述的入选标准，6项研究被纳入荟萃分析。一个随机效应模型显示，DTI参数FA是亚急性IS后上肢运动恢复的显著预测因子[相关系数=0.82; 95%置信区间-0.66至0.90，P值<0.001]。观察到中度异质性（Tau平方=0.12，I平方=62.14）。目前关于DTI与上肢运动功能恢复相关性的研究报道较少，且样本量较小。这项荟萃分析表明，DTI参数FA和上肢运动恢复之间有很强的相关性。需要设计良好的前瞻性试验嵌入较大的样本量，以建立这些结果。
Early evaluation of the pyramidal tract using Diffusion Tensor Imaging (DTI) is a prerequisite to decide the optimal treatment or to assess appropriate rehabilitation. The early predictive value of DTI for assessing motor and functional recovery in ischemic stroke (IS) has yielded contradictory results. The purpose is to systematically review and summarize the current available literature on the value of Fractional Anisotropy (FA) parameter of the DTI in predicting upper limb motor recovery after sub-acute IS. MEDLINE, PubMed, EMBASE, Google Scholar and Cochrane CENTRAL searches were conducted from January 1, 1950, to July 31, 2015, which was supplemented with relevant articles identified in the references. Correlation between FA and upper limb motor recovery measure was done. Heterogeneity was examined using Higgins I-squared, Tau-squared. Summary of correlation coefficient was determined using Random Effects model. Out of 166 citations, only eleven studies met the criteria for inclusion in the systematic review and six studies were included in the meta-analysis. A random effects model revealed that DTI parameter FA is a significant predictor for upper limb motor recovery after sub-acute IS [Correlation Coefficient=0.82; 95% Confidence Interval-0.66 to 0.90, P value<0.001]. Moderate heterogeneity was observed (Tau-squared=0.12, I-squared=62.14). The studies reported so far on correlation between DTI and upper limb motor recovery are few with small sample sizes. This meta-analysis suggests strong correlation between DTI parameter FA and upper limb motor recovery. Well-designed prospective trials embedded with larger sample size are required to establish these findings.