Fan Yang-teng, Lin Keh-chung, Liu Ho-ling, Chen Yao-liang, Wu Ching-yi
School of Occupational Therapy, College of Medicine, National Taiwan University, Taipei, Taiwan.
Division of Occupational Therapy, Department of Physical Medicine and Rehabilitation, National Taiwan University Hospital, Taipei, Taiwan.
Restor Neurol Neurosci. 2015;33(6):835-44. doi: 10.3233/RNN-150523.
Diffusion tensor imaging (DTI) studies indicate the structural integrity of the ipsilesional corticospinal tract (CST) and the transcallosal motor tract, which are closely linked to stroke recovery. However, the individual contribution of these 2 fibers on different levels of outcomes remains unclear. Here, we used DTI tractography to investigate whether structural changes of the ipsilesional CST and the transcallosal motor tracts associate with motor and functional recovery after stroke rehabilitation.
Ten participants with post-acute stroke underwent the Fugl-Meyer Assessment (FMA), the Wolf Motor Function Test (WMFT), the Functional Independence Measure (FIM), and DTI before and after bilateral robotic training.
All participants had marked improvements in motor performance, functional use of the affected arm, and independence in daily activities. Increased fractional anisotropy (FA) in the ipsilesional CST and the transcallosal motor tracts was noted from pre-treatment to the end of treatment. Participants with higher pre-to-post differences in FA values of the transcallosal motor tracts had greater gains in the WMFT and the FIM scores. A greater improvement on the FMA was coupled with increased FA changes along the ipsilesional CST.
These findings suggest 2 different structural indicators for post-stroke recovery separately at the impairment-based and function-based levels.
扩散张量成像（DTI）研究表明，患侧皮质脊髓束（CST）和胼胝体运动束的结构完整性与中风恢复密切相关。然而，这两条纤维在不同程度的恢复结果中的个体贡献仍不清楚。在此，我们使用DTI纤维束成像来研究患侧CST和胼胝体运动束的结构变化是否与中风康复后的运动和功能恢复相关。
10名急性中风后参与者在双侧机器人训练前后接受了Fugl-Meyer评估（FMA）、Wolf运动功能测试（WMFT）、功能独立性测量（FIM）和DTI检查。
所有参与者在运动表现、患侧手臂的功能使用和日常活动独立性方面都有显著改善。从治疗前到治疗结束，患侧CST和胼胝体运动束的分数各向异性（FA）增加。胼胝体运动束FA值治疗前后差异较大的参与者在WMFT和FIM评分上有更大的提高。FMA上更大的改善与患侧CST沿线FA变化的增加相关。
这些发现提示了中风后恢复在基于损伤和基于功能的水平上分别有两种不同的结构指标。
