Jang Sung Ho, Lee Jun, Yeo Sang Seok
Department of Physical Medicine and Rehabilitation, College of Medicine, Yeungnam University, Namku, Daegu, Republic of Korea.
Department of Neurology, College of Medicine, Yeungnam University, Namku, Daegu, Republic of Korea.
Neural Regen Res. 2017 Dec;12(12):2021-2024. doi: 10.4103/1673-5374.221159.
Many studies using diffusion tensor tractography (DTT) have demonstrated that injury of the spinothalamic tract (STT) is the pathogenetic mechanism of central post-stroke pain (CPSP) in intracerebral hemorrhage; however, there is no DTT study reporting the pathogenetic mechanism of CPSP in cerebral infarction. In this study, we investigated injury of the STT in patients with CPSP following cerebral infarction, using DTT. Five patients with CPSP following cerebral infarction and eight age- and sex-matched healthy control subjects were recruited for this study. STT was examined using DTT. Among DTT parameters of the affected STT, fractional anisotropy and tract volume were decreased by more than two standard deviations in two patients (patients 1 and 2) and three patients (patients 3, 4, and 5), respectively, compared with those of the control subjects, while mean diffusivity value was increased by more than two standard deviations in one patient (patient 2). Regarding DTT configuration, all affected STTs passed through adjacent part of the infarct and three STTs showed narrowing. These findings suggest that injury of the STT might be a pathogenetic etiology of CPSP in patients with cerebral infarction.
许多使用扩散张量纤维束成像（DTT）的研究表明，脊髓丘脑束（STT）损伤是脑出血后中枢性疼痛（CPSP）的发病机制；然而，尚无DTT研究报道脑梗死中CPSP的发病机制。在本研究中，我们使用DTT研究了脑梗死后CPSP患者的STT损伤情况。本研究招募了5例脑梗死后CPSP患者和8例年龄及性别匹配的健康对照者。使用DTT检查STT。在受影响的STT的DTT参数中，与对照者相比，2例患者（患者1和2）的分数各向异性和纤维束体积分别下降超过两个标准差，3例患者（患者3、4和5）的分数各向异性和纤维束体积也分别下降超过两个标准差，而1例患者（患者2）的平均扩散率值增加超过两个标准差。关于DTT形态，所有受影响的STT均穿过梗死灶的相邻部位，3条STT显示变窄。这些发现表明，STT损伤可能是脑梗死后CPSP患者的发病病因。
