Dawes H, Enzinger C, Johansen-Berg H, Bogdanovic M, Guy C, Collett J, Izadi H, Stagg C, Wade D, Matthews P M
Movement Science Group, School of Life Sciences, Oxford Brookes University, Gipsy Lane, Headington, Oxford, OX3 0BP, UK,
Exp Brain Res. 2008 Mar;186(2):325-33. doi: 10.1007/s00221-007-1237-0. Epub 2007 Dec 21.
We investigated the association between the degree of lesion overlap with the corticospinal tract and walking performance before and after 4-weeks of partial body weight support (PBWS) treadmill training in 18 individuals (ten male, eight female) with a mean age 59 +/- 13 years (mean +/- SD), range 32-74 years, who were ambulant and 6 months from a subcortical ischaemic stroke. Lesion volumes were manually defined on high resolution T1-weighted 3T-MRI scans and a probabilistic map of the corticospinal tract created using diffusion tensor imaging data collected previously in healthy subjects. The percentage overlap between the lesion and the corticospinal tract was calculated for each patient. Walking performance was determined by measures of 10 m speed, spatiotemporal parameters, percentage recovery of centre of mass (CoM), walking symmetry and 2-min endurance walk prior to and following 4 weeks of treadmill training with PBWS that emphasised normal fast walking. Lesion overlap measures weakly correlated with walking performance measures. Spatiotemporal and performance measures changed in response to training, but spatial symmetry and mechanical energy recovery did not. Walking speed at entry to the study predicted change in response to training of 10 m walk time and swing time asymmetry. Age and lesion overlap did not add to prediction of outcome models. The extent of lesion overlap with the corticospinal tract was not strongly associated with either walking performance or response to gait retraining, despite the correlation of these parameters with upper limb recovery.
我们调查了18名（10名男性，8名女性）平均年龄为59±13岁（平均±标准差）、年龄范围在32 - 74岁之间、能够行走且处于皮质下缺血性卒中后6个月的个体，在进行为期4周的部分体重支持（PBWS）跑步机训练前后，病变与皮质脊髓束的重叠程度与步行表现之间的关联。在高分辨率T1加权3T - MRI扫描上手动确定病变体积，并使用先前在健康受试者中收集的扩散张量成像数据创建皮质脊髓束的概率图谱。计算每位患者病变与皮质脊髓束之间的重叠百分比。步行表现通过10米速度、时空参数、质心（CoM）恢复百分比、步行对称性以及在强调正常快步行走的PBWS跑步机训练4周前后的2分钟耐力步行测量来确定。病变重叠测量与步行表现测量之间存在弱相关性。时空和表现测量因训练而改变，但空间对称性和机械能恢复未改变。研究开始时的步行速度可预测10米步行时间和摆动时间不对称性训练后的变化。年龄和病变重叠并未增加对结果模型的预测。尽管这些参数与上肢恢复相关，但病变与皮质脊髓束的重叠程度与步行表现或步态再训练反应均无强烈关联。
