Lee Ah Young, Choi Kyu Tae, Chang Min Cheol
Department of Rehabilitation Medicine, Daegu Veterans Health Service Medical Center, Daegu, Republic of Korea.
Department of Physical Medicine and Rehabilitation, College of Medicine, Yeungnam University, 317-1, Daemyungdong, Namku, Daegu, 705-717, Republic of Korea.
Transl Neurosci. 2020 Sep 9;11(1):328-333. doi: 10.1515/tnsci-2020-0114. eCollection 2020.
Skeletal muscle loss induces a poor rehabilitation outcome after stroke. Little is known about the usefulness of diffusion tensor tractography (DTT) findings of the corticospinal tract (CST) in terms of predicting muscle loss in affected limbs after stroke.
This research was designed as a preliminary study. Forty-four patients, with stroke onset more than one year earlier, were recruited. DTT was performed within 7-30 days after stroke onset. The patients were classified into two groups based on the DTT findings: a DTT+ group, in which the CST was preserved, and a DTT- group, in which the CST was interrupted by the stroke lesion. Additionally, the patients' functions were evaluated based on the modified Brunnstrom classification and functional ambulation category.
In the DTT- group, the values of the lean tissue mass of the affected upper and lower limbs were smaller than those of the unaffected side. On the other hand, in the DTT+ group, the values of the lean tissue mass between the affected and unaffected limbs were not significantly different.
The DTT evaluation of CST at the early stage of stroke may be useful for predicting muscle loss of the affected limb at the chronic stage in stroke patients.
骨骼肌损失会导致中风后康复效果不佳。关于皮质脊髓束(CST)的弥散张量纤维束成像(DTT)结果在预测中风后受累肢体肌肉损失方面的有用性,目前知之甚少。
本研究设计为一项初步研究。招募了44例中风发作超过一年的患者。在中风发作后7 - 30天内进行DTT检查。根据DTT结果将患者分为两组:CST保留的DTT +组和CST被中风病灶中断的DTT -组。此外,根据改良的Brunnstrom分类和功能性步行分类对患者的功能进行评估。
在DTT -组中,受累上肢和下肢的瘦组织质量值低于未受累侧。另一方面,在DTT +组中,受累和未受累肢体之间的瘦组织质量值无显著差异。
中风早期对CST进行DTT评估可能有助于预测中风患者慢性期受累肢体的肌肉损失。