Lench Daniel H, Hutchinson Scott, Woodbury Michelle L, Hanlon Colleen A
Departments of Psychiatry and Neurosciences, College of Medicine, Medical University of South Carolina, Charleston, SC.
Department of Health Research, College of Health Professions, Medical University of South Carolina, Charleston, SC.
Arch Rehabil Res Clin Transl. 2020 Jul 18;2(4):100075. doi: 10.1016/j.arrct.2020.100075. eCollection 2020 Dec.
To investigate the relationship between bimanual performance deficits measured using kinematics and callosum (CC) white matter changes that occur in people with chronic stroke.
Cross-sectional, observational study of participants with chronic stroke and age-matched controls.
Recruitment and assessments occurred at a stroke recovery research center. Behavioral assessments were performed in a controlled laboratory setting. Magnetic resonance imaging scans were performed at the Center for Biomedical Imaging.
Individuals were enrolled and completed the study (N=39; 21 participants with chronic stroke; 18 age-matched controls with at least 2 stroke risk factors).
Diffusion imaging metrics were obtained for each individual's CC and corticospinal tract (CST), including mean kurtosis (MK) and fractional anisotropy (FA). A battery of motor assessments, including bimanual kinematics, were collected from individuals while performing bimanual reaching.
Participants with stroke had lower FA and MK in the CST of the lesioned hemisphere when compared with the non-lesioned hemisphere. The FA and MK values in the CST were correlated with measures of unimanual hand performance. In addition, participants with stroke had significantly lower FA and MK in the CC than matched controls. CC diffusion metrics positively correlated with hand asymmetry and trunk displacement during bimanual performance, even when correcting for age and lesion volume.
These data confirm previous studies that linked CST integrity to unimanual performance and provide new data demonstrating a link between CC integrity and both bimanual motor deficits and compensatory movements.
研究采用运动学测量的双手操作功能缺陷与慢性卒中患者胼胝体（CC）白质变化之间的关系。
对慢性卒中患者和年龄匹配的对照组进行横断面观察性研究。
在一个卒中康复研究中心进行招募和评估。行为评估在受控的实验室环境中进行。磁共振成像扫描在生物医学成像中心进行。
招募个体并完成研究（N = 39；21名慢性卒中患者；18名年龄匹配的对照组，至少有2个卒中风险因素）。
获取每个人的CC和皮质脊髓束（CST）的扩散成像指标，包括平均峰度（MK）和分数各向异性（FA）。在个体进行双手够物时，收集包括双手运动学在内的一系列运动评估。
与未受损半球相比，卒中患者受损半球的CST中FA和MK较低。CST中的FA和MK值与单手操作表现的测量指标相关。此外，卒中患者的CC中FA和MK显著低于匹配的对照组。即使校正年龄和病变体积，CC扩散指标与双手操作期间的手部不对称和躯干位移呈正相关。
这些数据证实了先前将CST完整性与单手操作表现联系起来研究，并提供了新的数据，证明CC完整性与双手运动功能缺陷和代偿运动之间存在联系。
