Characteristics of injury of the corticospinal tract and corticoreticular pathway in hemiparetic patients with putaminal hemorrhage.
Characteristics of injury of the corticospinal tract and corticoreticular pathway in hemiparetic patients with putaminal hemorrhage.
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DOI：
10.1186/1471-2377-14-121
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发表时间：
2014-06-06
期刊：
影响因子：
2.6
通讯作者：
Jang SH
中科院分区：
文献类型：
--
作者：
Yoo JS;Choi BY;Chang CH;Jung YJ;Kim SH;Jang SH
关于壳核出血患者皮质脊髓束（CST）或皮质网状通路（CRP）损伤的特征尚未报道。本研究应用弥散张量纤维束成像技术，探讨脑卒中患者壳核出血时CST和CRP的损伤特点。本研究招募了57名连续的壳核出血患者和57名健康对照受试者。发病早期（8 ~ 30 d）行弥散张量成像检查。我们根据结构（神经束中断）或异常DTT参数（各向异性分数值或纤维数量比正常对照组低两个标准差以上）定义CST或CRP损伤。运动指数、改良Brunnstrom分类和功能性Ambassador分类用于评价运动功能。57例患者中，41例（71.9%）CST受损，50例（87.8%）CRP受损，37例（64.9%）CST和CRP均受损。CST和CRP同时损伤组的三项运动功能均显著低于CST和CRP同时损伤组（p < 0.05）。我们的研究结果表明，壳核出血经常伴随着CST和CRP的损伤，CRP似乎比CST更容易受到壳核出血。这些结果表明，有必要同时评估壳核出血患者的CRP和CST。
No study on the characteristics of injury of the corticospinal tract (CST) or corticoreticular pathway (CRP) in patients with putaminal hemorrhage has been reported. In this study, using diffusion tensor tractography, we attempted to investigate the characteristics of injury of the CST and CRP in hemiparetic patients with putaminal hemorrhage. Fifty seven consecutive patients with putaminal hemorrhage and 57 healthy control subjects were recruited for this study. Diffusion tensor imaging was performed during the early period (8 ~ 30 days) after onset. We defined injury of the CST or CRP in terms of the configuration (discontinuation of a neural tract) or abnormal DTT parameters (the fractional anisotrophy value or fiber number was more than two standard deviations lower than that of normal control subjects). The Motricity Index, the modified Brunnstrom Classification, and the Functional Ambulation Categories were used for evaluation of motor function. Among 57 patients, injury of the CST was found in 41 patients (71.9%) and injury of the CRP was found in 50 patients (87.8%), respectively, and 37 patients (64.9%) had injury of both the CST and CRP. All three motor functions of patients with injury of both the CST and CRP were significantly lower than those of patients with injury of either the CST or CRP (p < 0.05). Our results indicate that the putaminal hemorrhage frequently accompanies injury of both the CST and CRP, and the CRP appears to be more vulnerable to putaminal hemorrhage than the CST. These findings suggest the necessity for evaluation of both the CRP and the CST in patients with putaminal hemorrhage.
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