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单侧脑卒中患者患侧上肢运动功能与胼胝体完整性的关系：一项扩散张量成像研究

Relationship Between Ipsilesional Upper Extremity Motor Function and Corpus Callosum Integrity in Patients With Unilateral Stroke: A Diffusion Tensor Imaging Study.

作者信息

Kwon Bo Mi, Lee Yejin, Lee Hyun Haeng, Ko Nayeon, Kim Hyuntae, Kim Bo-Ram, Moon Won-Jin, Lee Jongmin

机构信息

Department of Rehabilitation Medicine, Konkuk University School of Medicine and Konkuk University Medical Center, Seoul, Korea.

Program in Occupational Therapy, Washington University School of Medicine, St. Louis, MO, USA.

出版信息

Brain Neurorehabil. 2022 Mar 23;15(1):e7. doi: 10.12786/bn.2022.15.e7. eCollection 2022 Mar.

DOI:10.12786/bn.2022.15.e7
PMID:36743845
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC9833466/
Abstract

This study aims to investigate the relationship between ipsilesional upper extremity (UE) motor function and the integrity of the subregions of the corpus callosum in hemiparetic stroke patients with motor deficits of the dominant or non-dominant ipsilesional side. Twenty participants with unilateral UE deficits after stroke were included. Each of the 10 participants had lesions on the left and right sides. The ipsilesional UE function was assessed with the Jebsen-Taylor hand function test (JHFT), the 9-hole peg test (9HPT), and grip and pinch strength tests. Fractional anisotropy (FA) was calculated for the integrity of the 5 subregions of the corpus callosum. Pearson's correlation analysis was conducted to investigate the relationship between UE function and the integrity of the callosal subregions. The results of JHFT and 9HPT showed a significant correlation with the FA value of the corpus callosum I projecting to the frontal lobe in the left lesion group (p < 0.05). There was no correlation between the ipsilesional UE motor function and the FA value of the ulnar subregion in the right lesion group (p > 0.05). These results showed that the motor deficits of the ipsilesional UE correlated with the integrity of callosal fiber projection to the prefrontal area when the ipsilesional side was non-dominant.

摘要

本研究旨在探讨患侧上肢（UE）运动功能与优势或非优势患侧存在运动功能缺损的偏瘫性脑卒中患者胼胝体各亚区完整性之间的关系。纳入了20例脑卒中后单侧UE功能缺损的参与者。10名参与者中每人在左侧和右侧均有损伤。采用Jebsen - Taylor手功能测试（JHFT）、9孔插钉测试（9HPT）以及握力和捏力测试对患侧UE功能进行评估。计算胼胝体5个亚区完整性的分数各向异性（FA）。进行Pearson相关性分析以研究UE功能与胼胝体亚区完整性之间的关系。JHFT和9HPT的结果显示，左侧损伤组中投射至额叶的胼胝体I的FA值与之存在显著相关性（p < 0.05）。右侧损伤组中患侧UE运动功能与尺侧亚区的FA值之间无相关性（p > 0.05）。这些结果表明，当患侧为非优势侧时，患侧UE的运动功能缺损与胼胝体纤维投射至前额叶区域的完整性相关。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6311/9833466/3870ffefd085/bn-15-e7-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6311/9833466/ff5adab4cdaf/bn-15-e7-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6311/9833466/3870ffefd085/bn-15-e7-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6311/9833466/ff5adab4cdaf/bn-15-e7-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6311/9833466/3870ffefd085/bn-15-e7-g002.jpg

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2
Increased functional connectivity between cortical hand areas and praxis network associated with training-related improvements in non-dominant hand precision drawing.与非优势手精确绘图中与训练相关的改善相关的皮质手部区域和运动网络之间功能连接增加。
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The microstructural status of the corpus callosum is associated with the degree of motor function and neurological deficit in stroke patients.
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PLoS One. 2015 Apr 15;10(4):e0122615. doi: 10.1371/journal.pone.0122615. eCollection 2015.
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Bilateral Synergy: A Framework for Post-Stroke Rehabilitation.双侧协同作用：中风后康复的一个框架。
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Compensatory changes accompanying chronic forced use of the nondominant hand by unilateral amputees.单侧截肢者使用非优势手进行慢性强制使用时的代偿变化。
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