Department of Physical Therapy, Yeungnam College of Science & Technology, Yeungnam University, Daemyungdong, Namku, Taegu, Republic of Korea.
J Rehabil Med. 2011 Apr;43(5):430-4. doi: 10.2340/16501977-0793.
This study compared the usefulness of transcranial magnetic stimulation (TMS), diffusion tensor tractography (DTT), and the combined study of TMS and DTT for prediction of motor outcome in patients with corona radiata infarct.
Fifty-eight patients with complete motor weakness of the affected hand were recruited. TMS and DTT were performed in the early stage (7-28 days) of stroke. Patients were classified into 2 groups according to the presence of motor evoked potential in affected hand muscle, and according to the preservation of integrity of the affected corticospinal tract on DTT.
The specificity of TMS (0.93) was higher than that of DTT (0.48), and the sensitivity of DTT (0.86) was higher than that of TMS (0.66). There was a good outcome in 89.5% of patients with TMS (+) and DTT (+), which was similar to the patients (90.5%) with single TMS (+). In contrast, there was a poor outcome in 87.5% of patients with TMS (-) and DTT (-), which was higher than those with single TMS (-) (73.0%) or DTT (-) (77.8%).
TMS showed higher positive predictability and DTT showed higher negative predictability. The combined study of TMS and DTT appeared to be more advantageous in prediction of negative motor outcome than did each single study. Single TMS appeared to be more advantageous in prediction of positive motor outcome.
本研究比较了经颅磁刺激（TMS）、弥散张量纤维束成像（DTT）以及 TMS 和 DTT 联合研究对放射冠梗死患者运动预后的预测价值。
共招募了 58 例患手完全运动无力的患者。TMS 和 DTT 在卒中后早期（7-28 天）进行。根据患手肌肉运动诱发电位的存在情况以及 DTT 上受累皮质脊髓束完整性的保留情况，将患者分为 2 组。
TMS 的特异性（0.93）高于 DTT（0.48），DTT 的敏感性（0.86）高于 TMS（0.66）。TMS（+）和 DTT（+）的患者中，89.5%预后良好，与 TMS（+）单一阳性的患者（90.5%）相似。相比之下，TMS（-）和 DTT（-）的患者中，87.5%预后不良，高于 TMS（-）单一阴性（73.0%）或 DTT（-）单一阴性（77.8%）的患者。
TMS 具有较高的阳性预测价值，DTT 具有较高的阴性预测价值。与单一研究相比，TMS 和 DTT 的联合研究似乎在预测阴性运动预后方面更具优势。单一 TMS 似乎在预测阳性运动预后方面更具优势。
