Interhemispheric Pathways Are Important for Motor Outcome in Individuals with Chronic and Severe Upper Limb Impairment Post Stroke.
Interhemispheric Pathways Are Important for Motor Outcome in Individuals with Chronic and Severe Upper Limb Impairment Post Stroke.
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DOI：
10.1155/2017/4281532
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发表时间：
2017
影响因子：
3.1
通讯作者：
Boyd LA
中科院分区：
文献类型：
--
作者：
Hayward KS;Neva JL;Mang CS;Peters S;Wadden KP;Ferris JK;Boyd LA
手臂损伤的严重程度不能单独解释中风后严重损伤的人的运动结果。明确脑生物标记物对中风后严重手臂损伤患者上肢运动结果的贡献。对15例重度(FM-UL ≤ 30/66)和14例轻-中度(FM-UL >； 40/66)患者的偏瘫手臂功能损害(Fugl-Meyer上肢，FM-UL)和功能(Wolf运动功能测试率，WMFT-Rate)进行了测定。经颅磁刺激和弥散加权成像指标化皮质脊髓束和胼胝体的结构和功能。对卒中后单个慢性时间点(≥6个月)可能的生物标志物和运动结果之间的关系进行了单独的模型研究。年龄(ΔR20.365，p=0.017)和患侧-经穹隆抑制(ΔR20.182，p=0.048)解释了偏瘫患者WMFT率的54.7%(p=0.009)差异。前额叶硬痂分数各向异性(PF-CC FA)单独解释了FM-UL结果的49.3%(p=0.007)变异。相同的模型不能解释轻-中度卒中的显著差异。在重度组中，PF-CC FA的k均值聚类分析区分了两个亚组，按临床上有意义和显著差异的运动障碍(p=0.049)和功能(p=0.006)结果分开。在慢性和严重手臂损伤的人群中，可能的运动结果的生物标记物是胼胝体的功能和结构。
Severity of arm impairment alone does not explain motor outcomes in people with severe impairment post stroke. Define the contribution of brain biomarkers to upper limb motor outcomes in people with severe arm impairment post stroke. Paretic arm impairment (Fugl-Meyer upper limb, FM-UL) and function (Wolf Motor Function Test rate, WMFT-rate) were measured in 15 individuals with severe (FM-UL ≤ 30/66) and 14 with mild–moderate (FM-UL > 40/66) impairment. Transcranial magnetic stimulation and diffusion weight imaging indexed structure and function of the corticospinal tract and corpus callosum. Separate models of the relationship between possible biomarkers and motor outcomes at a single chronic (≥6 months) time point post stroke were performed. Age (ΔR20.365, p = 0.017) and ipsilesional-transcallosal inhibition (ΔR20.182, p = 0.048) explained a 54.7% (p = 0.009) variance in paretic WMFT-rate. Prefrontal corpus callous fractional anisotropy (PF-CC FA) alone explained 49.3% (p = 0.007) variance in FM-UL outcome. The same models did not explain significant variance in mild–moderate stroke. In the severe group, k-means cluster analysis of PF-CC FA distinguished two subgroups, separated by a clinically meaningful and significant difference in motor impairment (p = 0.049) and function (p = 0.006) outcomes. Corpus callosum function and structure were identified as possible biomarkers of motor outcome in people with chronic and severe arm impairment.
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