七种不同的 DTI 衍生指标在慢性脑卒中幸存者中对皮质脊髓束结构特征的比较。
A comparison of seven different DTI-derived estimates of corticospinal tract structural characteristics in chronic stroke survivors.
机构信息
Department of Physical Therapy Education, SUNY Upstate Medical University, Syracuse, NY, United States.
Div. of Biokinesiology and Physical Therapy, University of Southern California, Los Angeles, CA, United States; Dept. of Neurology, University of Southern California, Los Angeles, CA, United States.
出版信息
J Neurosci Methods. 2018 Jul 1;304:66-75. doi: 10.1016/j.jneumeth.2018.04.010. Epub 2018 Apr 21.
BACKGROUND
Different diffusion tensor imaging (DTI) has been used to estimate corticospinal tract (CST) structure in the context of stroke rehabilitation research. However, there is no gold standard for the estimate of CST structure in chronic stroke survivors. This study aims to determine the most accurate DTI-derived CST estimate that is associated with a clinical motor outcome measure.
METHODS
We obtained imaging and behavioral data from a phase-I stroke rehabilitation clinical trial. We included thirty-seven chronic stroke survivors with mild-to-moderate motor impairment. Imaging data were processed using BrainSuite16a software. We calculated mean FA for each of 7 different ROIs/VOIs that include manually drawn 2-D ROIs and 3-D VOIs of CST from individual tractography or standard atlas. We compared ipsi- and contralesional CST FA for each method. Partial correlation was conducted between each CST FA asymmetry index and a time-based motor outcome measure, controlling for age and chronicity.
RESULTS
Ipsilesional CST FA was significantly lower than contralesional CST FA for each of the 7 methods Only CST FA asymmetry from the 3-D individual CST tractography showed a significant correlation with the primary motor outcome (r = 0.46, p = .005), while CST FA from the other six methods did not.
COMPARISON WITH EXISTING METHODS
Compared to the six other methods, CST FA asymmetry from 3-D individual tractography is the most accurate estimate of CST structure in this cohort of stroke survivors.
CONCLUSION
We recommend this method for future research seeking to understand brain-behavior mechanisms of motor recovery in chronic stroke survivors.
背景
不同的弥散张量成像（DTI）已被用于在中风康复研究中估计皮质脊髓束（CST）结构。然而，对于慢性中风幸存者的 CST 结构，没有金标准的估计方法。本研究旨在确定与临床运动结果测量最相关的最准确的 DTI 衍生 CST 估计值。
方法
我们从一期中风康复临床试验中获得了影像学和行为学数据。我们纳入了 37 名患有轻度至中度运动障碍的慢性中风幸存者。使用 BrainSuite16a 软件处理影像学数据。我们计算了 7 种不同 ROI/VOI 的平均 FA，这些 ROI/VOI 包括从个体追踪或标准图谱手动绘制的 CST 的 2-D ROI 和 3-D VOI。我们比较了每种方法的同侧和对侧 CST FA。在控制年龄和慢性的情况下，对每个 CST FA 不对称指数与基于时间的运动结果测量之间进行部分相关分析。
结果
对于 7 种方法中的每一种，同侧 CST FA 均明显低于对侧 CST FA。只有来自 3-D 个体 CST 追踪的 CST FA 不对称性与主要运动结果呈显著相关性（r=0.46，p=0.005），而其他 6 种方法的 CST FA 则没有。
与现有方法的比较
与其他 6 种方法相比，3-D 个体追踪的 CST FA 不对称性是本队列中风幸存者 CST 结构的最准确估计值。
结论
我们建议在未来的研究中使用这种方法，以了解慢性中风幸存者运动恢复的脑-行为机制。
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