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多发性硬化症患者胼胝体的各向异性分数和平均扩散率:物理治疗的影响。

Fractional anisotropy and mean diffusivity in the corpus callosum of patients with multiple sclerosis: the effect of physiotherapy.

机构信息

MR Unit, Department of Diagnostic and Interventional Radiology, Institute for Clinical and Experimental Medicine, Videnska 1958/9 Prague, Czech Republic.

出版信息

Neuroradiology. 2011 Nov;53(11):917-26. doi: 10.1007/s00234-011-0879-6. Epub 2011 May 10.

Abstract

INTRODUCTION

Modulation of neurodegeneration by physical activity is an active topic in contemporary research. The purpose of this study was to investigate changes in the brain's microstructure in multiple sclerosis (MS) after facilitation physiotherapy.

METHODS

Eleven patients with MS were examined using motor and neuropsychological testing and multimodal MRI at the beginning of the study, with second baseline measurement after 1 month without any therapy, and after a 2-month period of facilitation physiotherapy. Eleven healthy controls were examined at the beginning of the study and after 1 month. Fractional anisotropy (FA), mean diffusivity (MD), axial diffusivity (λ (ax)), and radial diffusivity (λ (rad)) were calculated for the whole corpus callosum (CC) in the midsagittal slice of T1W 3D MPRAGE spatially normalized images. Data were analyzed using linear mixed-effect models, paired, and two-sample tests.

RESULTS

At the baseline, patients with MS showed significantly lower values in FA (p < 0.001), and significantly higher values in MD (p < 0.001), λ (ax) (p = 0.003), and λ (rad) (p < 0.001) compared to control subjects. The FA, MD, λ (ax), and λ (rad) did not change between the first and second baseline examinations in either group. Differences 2 months after initiating facilitation physiotherapy were in FA, MD, and in λ (rad) significantly higher than differences in healthy controls (p < 0.001 for FA, p = 0.02 for MD, and p = 0.002 for λ (rad)). In MS patients, FA in the CC significantly increased (p < 0.001), MD and λ (rad) significantly decreased (p = 0.014 and p = 0.002), and thus approached the values in healthy controls.

CONCLUSION

The results of the study show that facilitation physiotherapy influences brain microstructure measured by DTI.

摘要

简介

运动对神经退行性变的调节是当代研究的一个活跃课题。本研究的目的是探讨促进物理疗法后多发性硬化症(MS)患者大脑微观结构的变化。

方法

11 名 MS 患者在研究开始时接受运动和神经心理学测试以及多模态 MRI 检查,在没有任何治疗的情况下,1 个月后进行第二次基线测量,然后进行 2 个月的促进物理治疗。11 名健康对照者在研究开始时和 1 个月后进行检查。在 T1W 3D MPRAGE 空间归一化图像的中矢状切片上计算整个胼胝体(CC)的分数各向异性(FA)、平均扩散系数(MD)、轴向扩散系数(λ (ax))和径向扩散系数(λ (rad))。使用线性混合效应模型、配对和两样本检验分析数据。

结果

在基线时,MS 患者的 FA 值明显较低(p < 0.001),MD 值明显较高(p < 0.001),λ (ax) 值(p = 0.003)和 λ (rad) 值(p < 0.001)均明显高于对照组。两组在第一次和第二次基线检查之间,FA、MD、λ (ax) 和 λ (rad) 均无变化。在开始促进物理治疗 2 个月后,FA、MD 和 λ (rad) 的差异明显高于健康对照组(FA 差异具有统计学意义(p < 0.001),MD 差异具有统计学意义(p = 0.02),λ (rad) 差异具有统计学意义(p = 0.002))。在 MS 患者中,CC 的 FA 值显著增加(p < 0.001),MD 和 λ (rad) 值显著降低(p = 0.014 和 p = 0.002),接近健康对照组的数值。

结论

研究结果表明,促进物理疗法会影响通过 DTI 测量的大脑微观结构。

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