Wang Peipei, Jia Xiuqin, Zhang Miao, Cao Yanxiang, Zhao Zhilian, Shan Yi, Ma Qingfeng, Qian Tianyi, Wang Jingjuan, Lu Jie, Li Kuncheng
Department of Radiology, Xuanwu Hospital, Capital Medical University, Beijing, China.
Beijing Key Laboratory of Magnetic Resonance Imaging and Brain Informatics, Beijing, China.
Front Neurol. 2018 Jun 1;9:312. doi: 10.3389/fneur.2018.00312. eCollection 2018.
The mechanisms of motor functional recovery after pontine infarction (PI) remain unclear. Here, we assessed longitudinal changes in gray matter volume (GMV) and examined the relationship between GMV and clinical outcome. Fifteen patients with unilateral PI underwent magnetic resonance imaging and neurological exams five times during a period of 6 months. Another 15 healthy participants were enrolled as the normal control (NC) group and were examined with the same protocol. The MR exam included routine protocol and a 3D T1-weighted magnetization-prepared rapid acquisition gradient echo scan. Changes in GMV were assessed using voxel-based morphometry. Furthermore, the correlations between GMV changes in regions of interest and clinical scores were assessed. Compared with NCs, the decreased GMVs in the contralateral uvula of cerebellum and the ipsilateral tuber of cerebellum were detected at third month after stroke onset. At the sixth month after stroke onset, the decreased GMVs were detected in the contralateral culmen of cerebellum, putamen, as well as in the ipsilateral tuber/tonsil of cerebellum. Compared with NC, the PI group exhibited significant increases in GMV at each follow-up time point relative to stroke onset. Specifically, the significant GMV increase was found in the ipsilateral middle frontal gyrus and ventral anterior nucleus of thalamus at second week after stroke onset. At first month after stroke onset, the increased GMVs in the ipsilateral middle temporal gyrus were detected. The significant GMV increase in the ipsilateral mediodorsal thalamus was noted at third month after stroke onset. At the end of sixth month after stroke onset, the GMV increase was found in the ipsilateral mediodorsal thalamus, superior frontal gyrus, and the contralateral precuneus. Across five times during a period of 6-month, a negative correlation was observed between mean GMV in the contralateral uvula, culmen, putamen, and ipsilateral tuber/tonsil and mean Fugl-Meyer (FM) score. However, mean GMV in the ipsilateral mediodorsal thalamus was positively correlated with mean FM score. Our findings suggest that structural reorganization of the ipsilateral mediodorsal thalamus might contribute to motor functional recovery after PI.
脑桥梗死（PI）后运动功能恢复的机制尚不清楚。在此，我们评估了灰质体积（GMV）的纵向变化，并研究了GMV与临床结局之间的关系。15例单侧PI患者在6个月内接受了5次磁共振成像和神经学检查。另外15名健康参与者作为正常对照组（NC），并按照相同方案进行检查。磁共振检查包括常规方案和三维T1加权磁化准备快速采集梯度回波扫描。使用基于体素的形态测量法评估GMV的变化。此外，还评估了感兴趣区域GMV变化与临床评分之间的相关性。与NC组相比，在卒中发作后第三个月，对侧小脑蚓垂和同侧小脑结节的GMV降低。在卒中发作后第六个月，对侧小脑山顶、壳核以及同侧小脑结节/扁桃体的GMV降低。与NC组相比，PI组在每个随访时间点相对于卒中发作时GMV均显著增加。具体而言，在卒中发作后第二周，同侧额中回和丘脑腹前核的GMV显著增加。在卒中发作后第一个月，检测到同侧颞中回的GMV增加。在卒中发作后第三个月，同侧丘脑背内侧核的GMV显著增加。在卒中发作后第六个月末，同侧丘脑背内侧核、额上回和对侧楔前叶的GMV增加。在6个月的时间里进行的5次检查中，对侧小脑蚓垂、山顶、壳核以及同侧小脑结节/扁桃体的平均GMV与平均Fugl-Meyer（FM）评分之间呈负相关。然而，同侧丘脑背内侧核的平均GMV与平均FM评分呈正相关。我们的研究结果表明，同侧丘脑背内侧核的结构重组可能有助于PI后运动功能的恢复。
