Department of Neurology, Institute of Clinical Neuroscience, The First Affiliated Hospital, Jinan University, Guangzhou 510632, Guangdong, China.
Department of Neurology, Clinical Medical College, Yangzhou University, Yangzhou 225000, Jiangsu, China.
Aging (Albany NY). 2020 Mar 8;12(5):4283-4298. doi: 10.18632/aging.102880.
Although many studies have focused on functional impairment after intracerebral hemorrhage, little is known about the relationship between secondary injuries to distal regions and neurological function. Our study aimed to evaluate the secondary injuries after intracerebral hemorrhage and explore their relationship to neurological functional outcome. Twenty-one patients with hemorrhages in supratentorial, deep locations and 10 healthy subjects were recruited. Longitudinal examinations of diffusion tensor imaging, hydrogen proton magnetic resonance spectroscopy imaging and neuropsychological assessment were performed after weeks 1 and 12 to elucidate the relationship between magnetic resonance imaging parameters and neurologic outcomes. By week 12, motor function had significantly improved, but cognitive function had deteriorated compared to week 1. Fractional anisotropy values for the ipsilateral cerebral peduncle correlated with motor function at week 1. No significant correlation between fractional anisotropy for the ipsilateral cerebral peduncle and the Fugl-Meyer Motor Scale was found at week 12. Fractional anisotropy values for the ipsilateral hippocampus were related to the Montreal Cognitive Assessment and Mini-Mental State Examination at weeks 1 and 12. Deep supratentorial hemorrhage may result in injury to distal regions, which correlate with impaired motor and cognitive function.
虽然许多研究都集中在脑出血后的功能障碍上,但对于远隔部位的继发性损伤与神经功能的关系知之甚少。我们的研究旨在评估脑出血后的继发性损伤,并探讨其与神经功能预后的关系。共招募了 21 例幕上深部脑出血患者和 10 名健康对照者。在第 1 周和第 12 周时进行弥散张量成像、氢质子磁共振波谱成像和神经心理学评估的纵向检查,以阐明磁共振成像参数与神经功能结局之间的关系。到第 12 周时,运动功能较第 1 周明显改善,但认知功能较第 1 周恶化。第 1 周时,患侧大脑脚的各向异性分数值与运动功能相关。第 12 周时,患侧大脑脚的各向异性分数值与 Fugl-Meyer 运动量表无明显相关性。第 1 周和第 12 周时,患侧海马的各向异性分数值与蒙特利尔认知评估和简易精神状态检查相关。深部幕上脑出血可能导致远隔部位损伤,与运动和认知功能障碍有关。