Stewart Jill Campbell, O'Donnell Michael, Handlery Kaci, Winstein Carolee J
1 University of South Carolina, Columbia, SC, USA.
2 University of Southern California, Los Angeles, CA, USA.
Neurorehabil Neural Repair. 2017 Jul;31(7):657-665. doi: 10.1177/1545968317712467. Epub 2017 Jun 6.
Recovery of arm function after stroke is often incomplete. An improved understanding of brain structure-motor behavior relationships is needed for the development of novel and targeted rehabilitation interventions.
To examine the relationship between skilled reach performance and the integrity of two putative white matter motor pathways, corticospinal tract and corpus callosum, after stroke.
Eleven individuals with chronic stroke (poststroke duration, mean 62.5 ± 42.4 months) and mild motor impairment (upper extremity Fugl-Meyer score, mean 54.2 ± 7.6) reached to six targets presented at three distances and two directions. Fractional anisotropy (FA) obtained from diffusion tensor imaging was used to determine the structural integrity of the corticospinal tract and the corpus callosum.
Overall reach performance was decreased in the paretic arm compared with the nonparetic arm. While FA was decreased in the ipsilesional corticospinal tract, FA in the corticospinal tract did not correlate with variability in reach performance between individuals. Instead, FA in the premotor section of the corpus callosum correlated with reach performance; individuals with higher FA in premotor corpus callosum tended to reach faster with both the paretic and nonparetic arms.
The structural connections between the two premotor and supplemental cortices that traverse the premotor corpus callosum may play an important role in supporting motor control and could become a target for interventions aimed at improved arm function in this population.
中风后手臂功能的恢复往往不完全。为了开发新的针对性康复干预措施，需要更好地理解脑结构与运动行为之间的关系。
研究中风后熟练伸手动作表现与两条假定的白质运动通路（皮质脊髓束和胼胝体）完整性之间的关系。
11名慢性中风患者（中风后持续时间，平均62.5±42.4个月）和轻度运动障碍患者（上肢Fugl-Meyer评分，平均54.2±7.6）向三个距离和两个方向呈现的六个目标伸手。从扩散张量成像获得的分数各向异性（FA）用于确定皮质脊髓束和胼胝体的结构完整性。
与非瘫痪侧手臂相比，瘫痪侧手臂的整体伸手动作表现下降。虽然患侧皮质脊髓束的FA降低，但皮质脊髓束中的FA与个体间伸手动作表现的变异性无关。相反，胼胝体运动前区的FA与伸手动作表现相关；胼胝体运动前区FA较高的个体，其瘫痪侧和非瘫痪侧手臂的伸手速度往往更快。
穿过胼胝体运动前区的两个运动前区和辅助运动区之间的结构连接可能在支持运动控制方面发挥重要作用，并可能成为旨在改善该人群手臂功能的干预目标。
