Association of transcallosal motor fibres with function of both hands after unilateral neonatal arterial ischemic stroke
Association of transcallosal motor fibres with function of both hands after unilateral neonatal arterial ischemic stroke
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DOI：
10.1111/dmcn.13517
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发表时间：
2017-10-01
影响因子：
3.8
通讯作者：
Dinomais, Mickael
中科院分区：
文献类型：
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作者：
Groeschel, Samuel;Hertz-Pannier, Lucie;Dinomais, Mickael
目的探讨单侧大脑中动脉区新生儿动脉缺血性卒中(NAIS)后痂体内运动神经纤维的受累情况及其与自身和对侧手功能的关系。方法采用高分辨率结构磁共振成像(MRI)、功能磁共振成像(FMRI)和磁共振弥散成像技术，对33例7岁NAIS患儿和31例典型发育中的7岁儿童进行比较。结果在控制病变体积和性别的情况下，NAIS治疗后儿童的运动总面积明显小于正常发育儿童(p|t|=0.034)，手运动能力明显小于正常发育儿童(pr(>；|t|)=0.006)。在一项特别后的分析中，评估了皮质脊髓束损伤的额外贡献。说明与典型的发育中的儿童相比，NAIS后的儿童表现出较小的运动部分，与对侧和自体的手动灵活性降低有关。这些结果表明，单侧NAIS中，跨痂运动神经纤维的作用可能与功能相关，也是所涉及的结构网络的重要组成部分，有待于进一步研究。
AimThe objective of this study was to investigate the involvement of the motor fibres of the corpus callosum after unilateral neonatal arterial ischemic stroke (NAIS) of the middle cerebral artery territory and the relationship to both ipsilesional and contralesional hand function.MethodUsing high-resolution structural magnetic resonance imaging (MRI), functional MRI, and magnetic resonance diffusion-tractography, we compared the midsagittal area of the motor part of the corpus callosum (defined by the fibres connecting the precentral gyri) between 33 7-year-old children after unilateral NAIS and 31 typically developing 7-year-old children. Hand motor performance was assessed by the box and blocks test.ResultsChildren after NAIS showed on average significantly smaller motor corpus callosum area compared to typically developing children (p|t|)=0.034) and ipsilesional hand motor performance (Pr(>|t|)=0.006) after controlling for lesion volume and sex. In a post-hoc analysis the additional contribution of corticospinal tract damage was evaluated.InterpretationCompared to typically developing children, children after NAIS exhibited a smaller motor part of their corpus callosum associated with reduced contralesional but also ipsilesional manual dexterity. These results indicate that the affection of transcallosal motor fibres in unilateral NAIS might be of functional relevance and an important part of the involved structural network that should be elucidated in further studies.