Motor outcome according to the integrity of the corticospinal tract determined by diffusion tensor tractography in the early stage of corona radiata infarct
Motor outcome according to the integrity of the corticospinal tract determined by diffusion tensor tractography in the early stage of corona radiata infarct
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DOI：
10.1016/j.neulet.2007.08.049
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发表时间：
2007-10-16
影响因子：
2.5
通讯作者：
Jang, Sung Ho
中科院分区：
文献类型：
--
作者：
Cho, Sang-Hyun;Kim, Dong Gyu;Jang, Sung Ho
弥散张量束成像 (DTT) 对于探索皮质脊髓束 (CST) 的状态非常有用。准确估计脑梗塞早期 CST 的完整性将能够确定运动恢复情况。进行 DTT 对放射冠梗死后的 CST 完整性进行分类，以评估该程序是否可以表征受影响手的运动结果。该研究招募了 55 名因放射冠梗死而双手完全瘫痪的患者，并在中风后 7-30 天内获得 DTT 图像。患者的 DTI 结果分为四组。 A型中，CST保留在梗塞周围；在B型中，CST起源于初级运动皮层以外的皮层；在C型中，CST在梗塞处中断；在D型中，CST由于退化而未能到达梗塞部位。中风后六个月，通过手的运动指数 (MI)、手指伸肌的医学研究委员会评分 (MRC) 和改良的 Brunnstrom 分类 (MBC) 来评估受影响手的运动功能。这些指数受到 DTT 类型的显着影响 (p < 0.05)。 DTT A 型患者的 MI、MRC 和 MBC 最高； DTT D 型患者的 MI、MRC 和 MBC 最低（p < 0.05）。在放射冠梗塞早期阶段获得的 DTT 确定的皮质脊髓束的完整性似乎有助于预测受影响手的运动结果。 (c) 2007 年，爱思唯尔爱尔兰有限公司出版。
Diffusion tensor tractography (DTT) is useful for exploring the state of the corticospinal tract (CST). An accurate estimation of the integrity of the CST in the early stage of a cerebral infarct would enable a determination of motor recovery. DTT was performed to classify CST integrity following a corona radiata infarct to evaluate if the procedure could characterize the motor outcome of the affected hand. Fifty-five patients with completely paralyzed hands due to a corona radiata infarct were recruited for the study, and DTT images were obtained within 7-30 days after a stroke. The DTI findings for the patients were classified into four groups. In type A, the CST was preserved around the infarct; in type B, the CST originated from a cortex other than the primary motor cortex; in type C, the CST was interrupted at the infarct; in type D, the CST failed to reach the infarct due to degeneration. Six months after a stroke, the motor function of the affected hand was evaluated with the motricity index (MI) for the hand, the Medical Research Council score (MRC) for finger extensors and the modified Brunnstrom classification (MBC). These indices were significantly influenced by the DTT type (p < 0.05). The highest MI, MRC and MBC were seen in the DTT type A patients; the lowest MI, MRC and MBC were seen in the DTT type D patients (p < 0.05). The integrity of the corticospinal tract determined by DTT obtained during the early stage of a corona radiata infarct seems to be helpful in predicting the motor outcome of the affected hand. (c) 2007 Published by Elsevier Ireland Ltd.