A longitudinal diffusion tensor imaging study on Wallerian degeneration of corticospinal tract after motor pathway stroke
A longitudinal diffusion tensor imaging study on Wallerian degeneration of corticospinal tract after motor pathway stroke
复制标题
运动通路卒中后皮质脊髓束华勒变性的纵向扩散张量成像研究
DOI：
10.1016/j.neuroimage.2009.04.066
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发表时间：
2009-08-15
期刊：
影响因子：
5.7
通讯作者：
Li, Kuncheng
中科院分区：
文献类型：
--
作者：
Yu, Chunshui;Zhu, Chaozhe;Li, Kuncheng
运动通路缺血性卒中后皮质脊髓束（CST）的华勒变性可通过弥散张量成像（DTI）来表征。然而，退变的皮质脊髓束中弥散指数的动态演变此前尚未完全明确。我们研究了这种动态演变以及退变的皮质脊髓束中弥散指数的早期变化与长期临床结果之间的关系。对9例首次发作的运动通路皮质下梗死患者在连续5个时间点，即1周内、2周、1个月、3个月和1年，重复进行弥散张量成像和神经系统检查。采用感兴趣区方法，我们分析了皮质脊髓束患侧和健侧之间的部分各向异性比率（rFA）、平均弥散率（rMD）、主特征值（rλ(1)）和横向特征值（rλ(23)）。我们未发现对侧皮质脊髓束的弥散指数在各时间点有任何显著变化。rFA在最初3个月单调下降，然后趋于稳定。rMD在2周后升高，并在第3个月后稳定。rλ(1)在最初2周下降，然后保持不变。rλ(23)在最初3个月升高，然后稳定。我们还发现，前2个时间点之间rFA的变化与1年后的美国国立卫生研究院卒中量表（NIHSS）（P = 0.00003）和运动指数（P = 0.0004）相关。我们的结果表明，对于运动通路卒中患者，退变的皮质脊髓束中的弥散指数在3个月内趋于稳定，并且皮质脊髓束rFA的早期变化可能预测长期临床结果。（C）2009爱思唯尔公司。保留所有权利。
Wallerian degeneration of the corticospinal tract (CST) after motor pathway ischemic stroke can be characterized by diffusion tensor imaging (DTI). However, the dynamic evolution of the diffusion indices in the degenerated CST has not previously been completely identified. We investigated this dynamic evolution and the relationship between early changes of the diffusion indices in the degenerated CST and long-term clinical Outcomes. DTI and neurological examinations were performed repeatedly in 9 patients with first-onset motor pathway subcortical infarction at 5 consecutive time points, i.e. within 1 week, at 2 weeks, 1 month, 3 months and 1 year. Using a region of interest method, we analyzed the ratios of the fractional anisotropy (rFA), mean diffusivity (rMD), primary eigenvalue (r lambda(1)) and transverse eigenvalue (r lambda(23)) between the affected and unaffected sides of the CSTs. We did not find any significant changes in the diffusion indices of the contralesional CSTs across time points. The rFA decreased monotonously during the first 3 months and then stabilized. The rMD increased after 2 weeks and stabilized after the third month. The r lambda(1) decreased during the first 2 weeks and then remained unchanged. The r lambda(23) increased during the first 3 months and then stabilized. We also found that the changes in the rFA between the first 2 time points were correlated with the NIHSS (P=0.00003) and the Motricity Indices (P=0.0004) after 1 year. Our results suggest that for patients with motor pathway stroke the diffusion indices in the degenerated CST stabilize within 3 months and that early changes in the rFA of the CST may predict long-term clinical outcomes. (C) 2009 Elsevier Inc. All rights reserved.