Degree of corticospinal tract damage correlates with motor function after stroke.
Degree of corticospinal tract damage correlates with motor function after stroke.
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DOI：
10.1002/acn3.132
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发表时间：
2014-11
影响因子：
5.3
通讯作者：
Mitsias, Panayiotis D.
中科院分区：
文献类型：
--
作者：
Maraka, Stefania;Jiang, Quan;Jafari-Khouzani, Kourosh;Li, Lian;Malik, Shaneela;Hamidian, Hajar;Zhang, Talan;Lu, Mei;Soltanian-Zadeh, Hamid;Chopp, Michael;Mitsias, Panayiotis D.
皮质脊髓束（CST）的直接损伤是定义中风后运动障碍的主要因素。扩散张量成像 (DTI) 纤维束成像可以定义 CST。我们试图确定基于 DTI 的 CST 损伤程度评估是否与缺血性中风每个阶段的运动障碍相关。我们通过 DTI 和临床运动评分（上肢 Fugl-Myer 测试 [UE-FM]、美国国立卫生研究院卒中量表 [mNIHSS] 的运动项目）评估了缺血性卒中急性（3-7 天）、亚急性（30 天）和慢性（90 天）阶段的患者。确定了 CST，并计算了受影响和对侧 CST 的虚拟纤维数 (FN)。我们使用Spearman相关性来研究FN比率（FNr）（受影响/未受影响的CST）与每个时间点运动评分的关系，并使用回归模型来研究急性参数与慢性运动评分的关联。我们研究了 23 名患者。平均年龄为 66.7 (±12) 岁。 FNr 与急性期（r = 0.50，P = 0.032）、亚急性期（r = 0.57，P = 0.007）和慢性期（r = 0.67，P = 0.0008）的 UE-FM 评分相关，并与急性期（r = -0.48，P = 0.043）、亚急性期（r = -0.58，P）的 mNIHSS 相关。 = 0.006）和慢性（r = -0.75，P = 0.0001）阶段。急性 NIHSS 和 FNr 的组合显着预测慢性 UE-FM 评分（r = 0.74，P = 0.0001）。 DTI 定义的 CST 损伤程度与缺血性中风每个阶段的运动障碍相关。基线 FNr 和 NIHSS 的结合可预测运动结果。 DTI 衍生的 CST 评估可能成为神经恢复临床试验设计中运动损伤的替代标志。
Direct injury to the corticospinal tract (CST) is a major factor defining motor impairment after stroke. Diffusion tensor imaging (DTI) tractography allows definition of the CST. We sought to determine whether DTI-based assessment of the degree of CST damage correlates with motor impairment at each phase of ischemic stroke. We evaluated patients at the acute (3–7 days), subacute (30 days), and chronic (90 days) phases of ischemic stroke with DTI and clinical motor scores (upper extremity Fugl-Myer test [UE-FM], motor items of the National Institutes of Health Stroke Scale [mNIHSS]). The CST was identified and virtual fiber numbers (FN) were calculated for the affected and contralateral CST. We used Spearman correlation to study the relationship of FN ratio (FNr) (affected/unaffected CST) with motor scores at each time point, and the regression model to study the association of the acute parameters with chronic motor scores. We studied 23 patients. Mean age was 66.7 (±12) years. FNr correlated with UE-FM score in the acute (r = 0.50, P = 0.032), subacute (r = 0.57, P = 0.007), and chronic (r = 0.67, P = 0.0008) phase, and with mNIHSS in the acute (r = −0.48, P = 0.043), subacute (r = −0.58, P = 0.006), and chronic (r = −0.75, P = 0.0001) phase. The combination of acute NIHSS and FNr significantly predicted chronic UE-FM score (r = 0.74, P = 0.0001). DTI-defined degree of CST injury correlates with motor impairment at each phase of ischemic stroke. The combination of baseline FNr and NIHSS predicts motor outcome. DTI-derived CST assessment could become a surrogate marker of motor impairment in the design of neurorestorative clinical trials.
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