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无论是在慢性中风患者还是健康对照者中,投射和连合纤维束均受到破坏:研究运动恢复的微观结构白质相关性。

Both projection and commissural pathways are disrupted in individuals with chronic stroke: investigating microstructural white matter correlates of motor recovery.

机构信息

Department of Physical Therapy, Faculty of Medicine, University of British Columbia, Vancouver, British Columbia, Canada.

出版信息

BMC Neurosci. 2012 Aug 29;13:107. doi: 10.1186/1471-2202-13-107.

Abstract

BACKGROUND

Complete recovery of motor function after stroke is rare with deficits persisting into the chronic phase of recovery. Diffusion tensor imaging (DTI) can evaluate relationships between white matter microstructure and motor function after stroke. The objective of this investigation was to characterize microstructural fiber integrity of motor and sensory regions of the corpus callosum (CC) and descending motor outputs of the posterior limb of the internal capsule (PLIC) in individuals with chronic stroke and evaluate the relationships between white matter integrity and motor function.

RESULTS

Standardized measures of upper extremity motor function were measured in thirteen individuals with chronic stroke. Manual dexterity was assessed in thirteen healthy age-matched control participants. DTI scans were completed for each participant. Fractional anisotropy (FA) of a cross-section of sensory and motor regions of the CC and the PLIC bilaterally were quantified. Multivariate analysis of variance evaluated differences between stroke and healthy groups. Correlational analyses were conducted for measures of motor function and FA. The stroke group exhibited reduced FA in the sensory (p = 0.001) region of the CC, contra- (p = 0.032) and ipsilesional (p = 0.001) PLIC, but not the motor region of the CC (p = 0.236). In the stroke group, significant correlations between contralesional PLIC FA and level of physical impairment (p = 0.005), grip strength (p = 0.006) and hand dexterity (p = 0.036) were observed.

CONCLUSIONS

Microstructural status of the sensory region of the CC is reduced in chronic stroke. Future work is needed to explore relationships between callosal sensorimotor fiber integrity and interhemispheric interactions post-stroke. In addition, contralesional primary motor output tract integrity is uniquely and closely associated with multiple dimensions of motor recovery in the chronic phase of stroke suggesting it may be an important biomarker of overall motor recovery.

摘要

背景

中风后运动功能很少能完全恢复,在恢复的慢性阶段仍存在缺陷。弥散张量成像(DTI)可以评估中风后白质微观结构与运动功能之间的关系。本研究的目的是描述慢性中风患者胼胝体(CC)运动和感觉区以及内囊后肢(PLIC)运动传出纤维的微观结构纤维完整性,并评估白质完整性与运动功能之间的关系。

结果

对 13 名慢性中风患者进行了上肢运动功能的标准化测量。13 名年龄匹配的健康对照者进行了手部灵巧性评估。对每位参与者进行了 DTI 扫描。双侧 CC 感觉和运动区及 PLIC 的横截面各向异性分数(FA)进行了量化。多变量方差分析评估了中风组和健康组之间的差异。对运动功能和 FA 进行了相关分析。中风组 CC 的感觉区(p=0.001)、对侧(p=0.032)和同侧(p=0.001)PLIC 的 FA 降低,但 CC 的运动区无差异(p=0.236)。在中风组中,对侧 PLIC FA 与身体损伤程度(p=0.005)、握力(p=0.006)和手灵巧性(p=0.036)呈显著相关。

结论

慢性中风患者 CC 的感觉区微观结构状态降低。未来需要进一步研究胼胝体感觉运动纤维完整性与中风后大脑半球间相互作用的关系。此外,对侧初级运动输出束的完整性与中风慢性期运动恢复的多个维度密切相关,这表明它可能是整体运动恢复的一个重要生物标志物。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a556/3547772/ebdd9a4703f2/1471-2202-13-107-1.jpg

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