Park Seo Yoon, Yeo Sang Seok, Jang Sung Ho, Cho In Hee, Oh Seunghue
Department of Physical Therapy, College of Health Sciences, Dankook University, Cheonan, South Korea.
Department of Physical Medicine and Rehabilitation, College of Medicine, Yeungnam University, Daegu, South Korea.
Front Neurol. 2021 Nov 3;12:740711. doi: 10.3389/fneur.2021.740711. eCollection 2021.
Parieto-insular vestibular cortex (PIVC) injury can cause symptoms such as abnormal gait and affects the integration and processing of sensory inputs contributing to self-motion perception. Therefore, this study investigated the association of the vestibular pathway in the gait and motor function recovery process in patients with PIVC injury using diffusion tensor imaging (DTI). We recruited 28 patients with stroke with only PIVC injury and reconstructed the PIVC using a 1.5-T scanner for DTI. Fractional anisotropy (FA), mean diffusivity (MD), and tract volume were measured. The functional ambulatory category (FAC) test was conducted, and motricity index (MI) score was determined. These were conducted and determined at the start (phase 1), end of rehabilitation (phase 2), and during the follow-up 6 months after onset. Although the tract volume of PIVC showed a decrease in subgroup A, all of DTI parameters were not different between two subgroups in affected side ( > 0.05). The results of MI and FAC were significantly different according to the recovery process ( < 0.05). In addition, FA of the PIVC showed a positive correlation with FAC in phase 2 of the recovery process on the affected side. On the unaffected side, FA of the PIVC showed a significant negative correlation with MI in all processes ( < 0.05). The degree of projection pathways to PIVC injury at onset time seems to be related to early restoration of gait function. Moreover, we believe that early detection of the projection pathway for PIVC injury using DTI would be helpful in the clinical evaluation and prediction of the prognosis of patients with PIVC injury.
顶叶岛叶前庭皮质（PIVC）损伤可导致异常步态等症状，并影响有助于自我运动感知的感觉输入的整合与处理。因此，本研究使用扩散张量成像（DTI）研究了PIVC损伤患者步态和运动功能恢复过程中前庭通路的相关性。我们招募了28例仅患有PIVC损伤的中风患者，并使用1.5-T扫描仪进行DTI以重建PIVC。测量了分数各向异性（FA）、平均扩散率（MD）和纤维束体积。进行了功能性步行分类（FAC）测试，并确定了运动指数（MI）评分。这些测试和评分在开始时（阶段1）、康复结束时（阶段2）以及发病后6个月的随访期间进行和确定。虽然A亚组中PIVC的纤维束体积有所减少，但患侧两个亚组之间的所有DTI参数均无差异（>0.05）。根据恢复过程，MI和FAC的结果有显著差异（<0.05）。此外，在患侧恢复过程的阶段2中，PIVC的FA与FAC呈正相关。在未患侧，PIVC的FA在所有过程中与MI均呈显著负相关（<0.05）。发病时PIVC损伤的投射通路程度似乎与步态功能的早期恢复有关。此外，我们认为使用DTI早期检测PIVC损伤的投射通路将有助于对PIVC损伤患者进行临床评估和预后预测。
