Neuroimaging and Stroke Recovery Laboratories, Department of Neurology, Beth Israel Deaconess Medical Center, Harvard Medical School , Boston, MA , USA ; Heart and Stroke Foundation Canadian Partnership in Stroke Recovery, Sunnybrook Research Institute , Toronto, ON , Canada ; Department of Physical Therapy, University of Toronto , Toronto, ON , Canada.
Front Neurol. 2013 Nov 7;4:178. doi: 10.3389/fneur.2013.00178. eCollection 2013.
Functional and structural reorganization in the brain occurs after stroke. The ability to predict motor outcomes may depend on patterns of brain functional and structural connectivity. We tested the hypothesis that alterations in motor transcallosal and corticospinal connections correlate with motor impairment in patients with chronic stroke. Eleven ischemic stroke patients underwent the Upper Extremity Fugl-Meyer (UE-FM) assessment, resting state functional magnetic resonance imaging, and diffusion tensor imaging (DTI). Twelve healthy control subjects underwent DTI. We assessed the temporal coupling in neural activity between interhemispheric motor cortex, and white matter integrity by means of fractional anisotropy (FA), in the transcallosal motor fibers and corticospinal tract. Partial correlation analyses were performed to determine whether these connectivity measures correlate with Upper UE-FM scores. Patients compared to controls had reduced FA in common voxels of transcallosal motor and ipsilesional corticospinal fibers. Within the patient group those with higher interhemispheric motor cortex connectivity and higher FA in the transcallosal motor fibers were less impaired. The results show that markers of functional and structural motor cortex connectivity correlate with motor impairment in the chronic stage of stroke.
大脑在中风后会发生功能和结构重组。预测运动结果的能力可能取决于大脑功能和结构连接的模式。我们检验了这样一个假设,即运动性胼胝体和皮质脊髓束连接的改变与慢性中风患者的运动障碍有关。11 名缺血性中风患者接受了上肢 Fugl-Meyer(UE-FM)评估、静息态功能磁共振成像和弥散张量成像(DTI)检查。12 名健康对照者接受了 DTI 检查。我们通过分形各向异性(FA)评估了大脑半球间运动皮质之间的神经活动的时间耦合,并评估了胼胝体运动纤维和皮质脊髓束的白质完整性。进行偏相关分析以确定这些连接测量值是否与 UE-FM 上肢评分相关。与对照组相比,患者的胼胝体运动纤维和同侧皮质脊髓束的共同体素 FA 降低。在患者组中,那些具有更高的大脑半球间运动皮质连接性和更高的胼胝体运动纤维 FA 的患者受损程度较低。结果表明,运动皮质功能和结构连接的标志物与中风慢性期的运动障碍有关。