Yeo Sang Seok, Jang Sung Ho, Oh Seunghue, Kwon Jung Won
Department of Physical Therapy, College of Health Sciences, Dankook University.
Department of Physical Medicine and Rehabilitation, College of Medicine, Yeungnam University.
Medicine (Baltimore). 2020 Apr;99(16):e19835. doi: 10.1097/MD.0000000000019835.
Pusher syndrome is a disorder of postural control. It is associated with unilateral lesions on central vestibular system. In the current study, we attempted to identify and investigate neural connectivity of the parieto-insular vestibular cortex in a patient with pusher syndrome, using diffusion tensor imaging.
A 60-year-old male patient had left hemiplegia due to an infarction on right premotor cortex, primary motor cortex, corona radiata and temporal and occipital lobe. The patient had severe motor weakness in left upper and lower limb, left side neglect and significant pusher syndrome.
Patient was diagnosed with left hemiplegia due to an infarction in the right middle cerebral artery territory at the neurology department of a university hospital.
One patient and 5 control subjects of similar age participated. Diffusion tensor imaging data were acquired at 4-month and 12-month after the initial injury.
Fractional anisotropy, mean diffusivity, and tract volume (TV) were measured. TV values in both affected and unaffected hemispheres of the patient were significantly decreased at 4-month compared to those of control subjects. In the unaffected hemisphere of the patient, TV value showed significant increase at 12-month compared to that at 4-month. Although the TV value at 12-month of the affected hemisphere was out of reference range, TV was considerably increased compared to that at 4-month. Mean values for fractional anisotropy or mean diffusivity in 2 hemispheres did not show significant difference compared to those of control subjects regardless of month.
Restoration of an injured projection pathway between the vestibular nuclei and parieto-insular vestibular cortex with recovery of pusher syndrome was found in a patient with stroke.
推搡综合征是一种姿势控制障碍。它与中枢前庭系统的单侧损伤有关。在本研究中，我们试图使用扩散张量成像来识别和研究一名推搡综合征患者的顶叶岛叶前庭皮质的神经连接。
一名60岁男性患者因右侧运动前皮质、初级运动皮质、放射冠以及颞叶和枕叶梗死而出现左侧偏瘫。该患者左侧上肢和下肢严重运动无力，左侧忽视且有明显的推搡综合征。
在一所大学医院的神经科，患者被诊断为右侧大脑中动脉区域梗死所致的左侧偏瘫。
一名患者和5名年龄相仿的对照受试者参与研究。在初次受伤后的4个月和12个月采集扩散张量成像数据。
测量了分数各向异性、平均扩散率和纤维束体积（TV）。与对照受试者相比，患者患侧和未患侧半球的TV值在4个月时均显著降低。在患者未患侧半球，与4个月时相比，12个月时TV值显著增加。尽管患侧半球12个月时的TV值超出参考范围，但与4个月时相比有相当大的增加。无论月份如何，两个半球的分数各向异性或平均扩散率的平均值与对照受试者相比均未显示出显著差异。
在一名中风患者中发现，随着推搡综合征的恢复，前庭核与顶叶岛叶前庭皮质之间受损的投射通路得以恢复。
