Recovery of motor functions following hemiparetic stroke:: A clinical and magnetic resonance-morphometric study
Recovery of motor functions following hemiparetic stroke:: A clinical and magnetic resonance-morphometric study
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DOI：
10.1159/000047650
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发表时间：
2001-01-01
影响因子：
2.9
通讯作者：
Freund, HJ
中科院分区：
文献类型：
--
作者：
Binkofski, F;Seitz, RJ;Freund, HJ
卒中后临床恢复程度的预测指标仍不明确。在这项研究中，我们试图评估临床数据和病变大小对缺血性卒中后运动恢复的预测价值。通过对52例偏瘫患者首次卒中后的手感觉运动功能评分，监测其临床康复过程。在质子密度磁共振图像上测量病变大小的进程。确定了三组患者。中度运动功能障碍患者在9d内基本恢复正常(17/17，第1组)。在整个6个月以上的观察期内，有严重运动功能障碍的患者基本恢复(16/35，第2组)或保持严重受损(19/35，第3组)，病变大小的变化与运动功能障碍之间无相关性。Logistic回归分析显示，只有初始运动评分才能预测良好的临床预后(p=0.006)，卒中后4周内初始运动评分的相对改善约20%似乎是良好预后的一个切入点。数据表明，轻度运动障碍的患者恢复良好，而严重运动障碍患者的结果可能不同。由于病变大小与预后无关，残馀功能的多少似乎是运动恢复能力的主要决定因素。版权所有(C)2001 S.Karger AG，巴塞尔。
Predictors for the degree of clinical recovery after stroke are still poorly defined. in this study we tried to assess the predictive value of clinical data and of lesion size for motor recovery after ischemic stroke. In 52 hemiparetic patients we monitored the course of clinical recovery by a dedicated score of sensorimotor hand function after their first stroke. The course of the lesion size was measured in proton density magnetic resonance images. Three groups of patients were identified. Patients with moderate initial motor deficit recovered almost completely within 9 days (17/17, group 1). From the patients with severe initial motor deficit, about equal numbers recovered (16/35, group 2) or remained severely impaired during the entire observation period of more than 6 months (19/35, group 3), There was no correlation between changes of lesion size and motor deficit. Logistic regression of probability of good clinical outcome on initial lesion size, initial motor score and subcortical versus cortical location of lesion showed that only the initial motor score was predictive (p = 0.006), A relative improvement of the initial motor score of about 20% in the first 4 weeks after stroke appeared to be a relevant cut point for good outcome. The data indicate that patients with mild initial motor deficits recover well, whereas severely affected patients may differ in outcome. Since lesion size was not correlated with outcome the amount of spared residual function appeared as major determinant for the capacity for motor recovery. Copyright (C) 2001 S. Karger AG, Basel.