Jang Sung Ho, Cho Min Jye
Department of Physical Medicine and Rehabilitation, College of Medicine, Yeungnam University, Namku, Taegu 42415, Korea.
Healthcare (Basel). 2022 Apr 14;10(4):731. doi: 10.3390/healthcare10040731.
This study investigated the relationship of the nigrostriatal tract (NST) with motor function and the corticospinal tract (CST) using diffusion tensor tractography in chronic hemiparetic stroke patients. Forty-three consecutive patients with putaminal hemorrhage in the chronic stage were recruited. The Motricity Index was used to evaluate the motor function of affected hemiparetic extremities. The fractional anisotropy and the tract volume of ipsilesional NST and ipsilesional CST were acquired. The tract volume ( = 0.824) of ipsilesional NST and fractional anisotropy ( = 0.682) and the tract volume ( = 0.886) of ipsilesional CST showed a strong positive correlation with the Motricity Index score. The fractional anisotropy of ipsilesional NST showed moderate positive correlations with the fractional anisotropy ( = 0.449) and tract volume ( = 0.353) of ipsilesional CST. The tract volume of ipsilesional NST showed strong positive correlations with the fractional anisotropy ( = 0.716) and the tract volume ( = 0.799) of ipsilesional CST. The regression model showed that the tract volumes of ipsilesional NST and ipsilesional CST were positively associated with the Motricity Index score (Adjusted R = 0.763, F = 45.998). Mediation analysis showed that the tract volume of ipsilesional CST partially mediated the effects of the tract volume of ipsilesional NST on the Motricity Index score ( = 3.34). A close relationship was found between ipsilesional NST and the motor function of affected extremities in chronic hemiparetic patients with putaminal hemorrhage. Moreover, ipsilesional NST influenced the motor function of affected extremities indirectly through ipsilesional CST.
本研究采用弥散张量纤维束成像技术,在慢性偏瘫性卒中患者中探究黑质纹状体束(NST)与运动功能及皮质脊髓束(CST)之间的关系。连续纳入43例慢性期壳核出血患者。采用运动功能指数评估患侧偏瘫肢体的运动功能。获取患侧NST和患侧CST的分数各向异性及纤维束体积。患侧NST的纤维束体积(=0.824)、分数各向异性(=0.682)以及患侧CST的纤维束体积(=0.886)与运动功能指数评分呈强正相关。患侧NST的分数各向异性与患侧CST的分数各向异性(=0.449)及纤维束体积(=0.353)呈中度正相关。患侧NST的纤维束体积与患侧CST的分数各向异性(=0.716)及纤维束体积(=0.799)呈强正相关。回归模型显示,患侧NST和患侧CST的纤维束体积与运动功能指数评分呈正相关(调整R=0.763,F=45.998)。中介分析表明,患侧CST的纤维束体积部分介导了患侧NST的纤维束体积对运动功能指数评分的影响(=3.34)。在慢性壳核出血偏瘫患者中,发现患侧NST与患侧肢体的运动功能之间存在密切关系。此外,患侧NST通过患侧CST间接影响患侧肢体的运动功能。