Trivedi Richa, Gupta Rakesh K, Shah Vipul, Tripathi Mukesh, Rathore Ram K S, Kumar Manoj, Pandey Chandra M, Narayana Ponnada A
Department of Radiodiagnosis, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow, India.
Pediatr Neurol. 2008 Nov;39(5):341-9. doi: 10.1016/j.pediatrneurol.2008.07.012.
Diffusion tensor imaging is used as a measure of white-matter organization to probe mechanisms underlying clinical responses. Diffusion tensor imaging and clinical assessment in 8 patients with spastic quadriparesis (mean age, 6.13 years) was performed before and 6 months after therapy (botulinum injection, followed by physiotherapy). All patients were graded on the basis of gross motor function. Serial diffusion tensor imaging was also performed on 10 age/sex-matched controls at baseline and after 6 months. Regions of interests were placed on corticospinal tracts at different levels (i.e., corona radiata, posterior limb of internal capsule, midbrain, pons, and upper medulla) and on other major white-matter tracts, in both patients and controls. A significant increase in fractional anisotropy was evident in corticospinal tracts at the level of the posterior limb of the internal capsule and periventricular white matter of the temporal lobe, relative to baseline values in the patient group. Gross motor function classification system grades improved in all patients during follow-up relative to baseline values. The increase in fractional anisotropy in corticospinal tracts, along with improved clinical motor scores, suggests plasticity of the central motor pathway after combined therapy.
扩散张量成像被用作一种衡量白质组织的方法，以探究临床反应背后的机制。对8例痉挛性四肢瘫患者（平均年龄6.13岁）在治疗前及治疗后6个月（肉毒杆菌注射，随后进行物理治疗）进行了扩散张量成像和临床评估。所有患者均根据粗大运动功能进行分级。还对10名年龄/性别匹配的对照者在基线时和6个月后进行了连续扩散张量成像。在患者和对照者中，在不同水平（即放射冠、内囊后肢、中脑、脑桥和延髓上部）的皮质脊髓束以及其他主要白质束上放置了感兴趣区域。相对于患者组的基线值，内囊后肢水平的皮质脊髓束和颞叶脑室周围白质的分数各向异性显著增加。在随访期间，所有患者的粗大运动功能分类系统评分相对于基线值均有所改善。皮质脊髓束分数各向异性的增加，以及临床运动评分的改善，表明联合治疗后中枢运动通路具有可塑性。
