Department of Physical Medicine and Rehabilitation, Physical Therapy Program, University of Colorado School of Medicine, Aurora, CO; Regis University School of Physical Therapy, Denver, CO.
Regis University School of Physical Therapy, Denver, CO; Craig Hospital, Englewood, CO.
Arch Phys Med Rehabil. 2022 Jan;103(1):62-68. doi: 10.1016/j.apmr.2021.07.792. Epub 2021 Aug 8.
To determine if lateral corticospinal tract (LCST) integrity demonstrates a significant predictive relationship with future ipsilateral lower extremity motor function (LEMS) and if dorsal column (DC) integrity demonstrates a significant predictive relationship with future light touch (LT) sensory function post spinal cord injury (SCI) at time of discharge from inpatient rehabilitation.
Retrospective analyses of imaging and clinical outcomes.
University and academic hospital.
A total of 151 participants (N=151) with SCI.
Inpatient rehabilitation.
LEMS and LT scores at discharge from inpatient rehabilitation.
In 151 participants, right LCST spared tissue demonstrated a significant predictive relationship with right LEMS percentage recovered (β=0.56; 95% confidence interval [CI], 0.37-0.73; R=0.43; P<.001). Left LCST spared tissue demonstrated a significant predictive relationship with left LEMS percentage recovered (β=0.66; 95% CI, 0.50-0.82; R=0.51; P<.001). DC spared tissue demonstrated a significant predictive relationship with LT percentage recovered (β=0.69; 95% CI, 0.52-0.87; R=0.55; P<.001). When subgrouping the participants into motor complete vs incomplete SCI, motor relationships were no longer significant, but the sensory relationship remained significant. Those who had no voluntary motor function but recovered some also had significantly greater LCST spared tissue than those who did not recover motor function.
LCST demonstrated significant moderate predictive relationships with lower extremity motor function at the time of discharge from inpatient rehabilitation, in an ipsilesional manner. DC integrity demonstrated a significant moderate predictive relationship with recovered function of LT. With further development, these neuroimaging methods might be used to predict potential deficits after SCI and to provide corresponding targeted interventions.
确定外侧皮质脊髓束（LCST）的完整性是否与脊髓损伤（SCI）后出院时同侧下肢运动功能（LEMS）的未来恢复有显著的预测关系，以及背柱（DC）的完整性是否与未来轻触（LT）感觉功能的恢复有显著的预测关系。
影像学和临床结果的回顾性分析。
大学和学术医院。
共 151 名 SCI 参与者（N=151）。
住院康复。
住院康复出院时的 LEMS 和 LT 评分。
在 151 名参与者中，右侧 LCST 保留组织与右侧 LEMS 恢复百分比（β=0.56；95%置信区间[CI]，0.37-0.73；R=0.43；P<.001）有显著的预测关系。左侧 LCST 保留组织与左侧 LEMS 恢复百分比（β=0.66；95% CI，0.50-0.82；R=0.51；P<.001）有显著的预测关系。DC 保留组织与 LT 恢复百分比（β=0.69；95% CI，0.52-0.87；R=0.55；P<.001）有显著的预测关系。当将参与者分为运动完全性和不完全性 SCI 亚组时，运动关系不再显著，但感觉关系仍然显著。那些没有自愿运动功能但恢复了一些运动功能的人，其 LCST 保留组织明显多于那些没有恢复运动功能的人。
LCST 与住院康复出院时同侧下肢运动功能有显著的中等预测关系，以同侧方式。DC 的完整性与 LT 功能的恢复有显著的中等预测关系。随着进一步的发展，这些神经影像学方法可能被用于预测 SCI 后的潜在缺陷，并提供相应的针对性干预。
