Department of Rehabilitation Science, Graduate School, Daegu University, Taegu, Republic of Korea.
Eur Neurol. 2011;65(6):332-7. doi: 10.1159/000324152. Epub 2011 May 17.
We attempted to investigate changes of the pedunculopontine nucleus (PPN) according to walking ability in chronic stroke patients, using diffusion tensor imaging (DTI).
55 consecutive chronic stroke patients who were not able to walk due to injury of the corticospinal tract (CST) at stroke onset and 22 age-matched normal control subjects were recruited. We measured the values of fractional anisotropy (FA) and apparent diffusion coefficient (ADC) of the PPN and assessed the walking ability of each patient.
In patients who were able to walk independently, the FA value of the PPN in the affected hemisphere was increased without change of the ADC value (p < 0.05). Increase of the FA value was positively correlated with the degree of walking ability (p < 0.05). In contrast, the ADC value was increased in the affected hemisphere of patients who could not walk, without change of the FA value (p < 0.05). This increase of the ADC value was negatively correlated with the degree of walking ability (p < 0.05).
We found that the neuronal activity of the PPN in the affected hemisphere was increased in stroke patients who were able to walk independently. Therefore, we think that the PPN in the affected hemisphere contributed to walking ability in stroke patients with CST injury.
我们试图通过弥散张量成像（DTI）来研究慢性卒中患者的脑脚桥核（PPN）根据步行能力的变化。
招募了 55 名连续的慢性卒中患者，这些患者在卒中发作时由于皮质脊髓束（CST）损伤而无法行走，以及 22 名年龄匹配的正常对照组。我们测量了 PPN 的各向异性分数（FA）和表观扩散系数（ADC）值，并评估了每位患者的步行能力。
在能够独立行走的患者中，患侧 PPN 的 FA 值增加，而 ADC 值没有变化（p < 0.05）。FA 值的增加与步行能力的程度呈正相关（p < 0.05）。相比之下，无法行走的患者患侧 PPN 的 ADC 值增加，而 FA 值没有变化（p < 0.05）。这种 ADC 值的增加与步行能力的程度呈负相关（p < 0.05）。
我们发现，能够独立行走的卒中患者患侧 PPN 的神经元活动增加。因此，我们认为，受损大脑半球的 PPN 有助于 CST 损伤的卒中患者的步行能力。
