Kim Jong Bum, Lee Jae Min, Son Su Min
Department of Physical Medicine and Rehabilitation, College of Medicine, Yeungnam University, Daegu 42415, Republic of Korea.
Department of Pediatric Medicine, College of Medicine, Yeungnam University, Daegu 42415, Republic of Korea.
Children (Basel). 2023 Jan 27;10(2):224. doi: 10.3390/children10020224.
This study aimed to evaluate children with lymphoblastic leukemia and examine the potential correlation between corticospinal tract (CST) injury and motor dysfunction prior to chemotherapy using diffusion tensor tractography (DTT). Nineteen consecutive patients with childhood leukemia (mean age 7.483 ± 3.1 years, range 4-12 years) with unilateral motor dysfunction who underwent DTT prior to chemotherapy and twenty healthy individuals (mean age 7.478 ± 1.2 years; range 4-12 years) were enrolled. Motor functions were evaluated by two independent investigators. The cause of neurological dysfunction was identified based on the CST state using mean fractional anisotropy (FA), mean fiber volume (FV), and CST integrity using DTT. All patients showed disrupted integrity and significantly decreased FA and FV in the affected CST compared to the unaffected CST and the control group ( < 0.05). These DTT results also corresponded to patients' unilateral motor dysfunction. Using DTT, we demonstrated that neurological dysfunction may occur in patients with childhood acute lymphoblastic leukemia even prior to chemotherapy, and that CST injuries correlate with motor dysfunction in these patients. DTT may be a useful modality for evaluating the neural tract state in pediatric leukemia patients with neurological dysfunction.
本研究旨在评估淋巴细胞白血病患儿，并利用弥散张量纤维束成像（DTT）检查化疗前皮质脊髓束（CST）损伤与运动功能障碍之间的潜在相关性。连续纳入19例化疗前接受DTT检查的单侧运动功能障碍的儿童白血病患者（平均年龄7.483±3.1岁，范围4 - 12岁）以及20名健康个体（平均年龄7.478±1.2岁；范围4 - 12岁）。由两名独立研究人员评估运动功能。基于CST状态，利用平均各向异性分数（FA）、平均纤维体积（FV）以及使用DTT评估的CST完整性来确定神经功能障碍的原因。与未受影响的CST及对照组相比，所有患者受累CST均显示完整性破坏，FA和FV显著降低（<0.05）。这些DTT结果也与患者的单侧运动功能障碍相符。利用DTT，我们证明儿童急性淋巴细胞白血病患者甚至在化疗前就可能出现神经功能障碍，且这些患者的CST损伤与运动功能障碍相关。DTT可能是评估伴有神经功能障碍的小儿白血病患者神经束状态的一种有用方法。
