Jacquemont Thomas, Valabregue Romain, Daghsen Lina, Moulton Eric, Zavanone Chiara, Lamy Jean Charles, Rosso Charlotte
Inserm U 1127, CNRS UMR 7225, Sorbonne Université, Institut du Cerveau et de la Moelle épinière, ICM, Paris, France.
STARE Team, iCRIN, Institut du Cerveau et de la Moelle épinière, ICM, Paris, France.
Front Neurol. 2023 Jul 14;14:1157625. doi: 10.3389/fneur.2023.1157625. eCollection 2023.
Parieto-frontal interactions are mediated by the superior longitudinal fasciculus (SLF) and are crucial to integrate visuomotor information and mediate fine motor control. In this study, we aimed to characterize the relation of white matter integrity of both parts of the SLF (SLF I and SLF II) to both motor outcome and recovery and its evolution over time in stroke patients with upper limb motor deficits.
Fractional anisotropy (FA) values over the SLF I, SLF II, and corticospinal tract (CST) and upper limb motor performance evaluated by both the upper limb Fugl-Meyer Assessment score and maximum grip strength were measured for 16 patients at 3 weeks, 6 weeks, and 12 weeks poststroke. FA changes were assessed over time using repeated-measures Friedman ANOVA, and correlations between motor recovery, motor outcome at 12 weeks, and FA values in the CST, SLF I, and SLF II at 3 weeks were performed using Spearman's rank-order correlation.
FA values in the affected hemisphere's SLF I and SLF II at 3 weeks correlated with motor recovery at 12 weeks when assessed by the Fugl-Meyer Assessment for upper limb extremity (rho: 0.502, p: 0.04 and rho: 0.510, p: 0.04, respectively) but not when assessed by grip strength. FA values in the SLF I and SLF II were not correlated with motor outcomes. FA values in the SLF II in the affected hemisphere changed significantly over time (p: 0.016).
Both SLF I and SLF II appeared to participate in poststroke motor recovery of complex movements but not in the motor outcome. These results argue that visually/spatially oriented motor tasks as well as more complex motor tasks using parietal associative areas should be used for poststroke rehabilitation strategies.
顶叶-额叶的相互作用由上纵束（SLF）介导，对于整合视觉运动信息和介导精细运动控制至关重要。在本研究中，我们旨在描述上纵束两部分（SLF I和SLF II）的白质完整性与运动结果和恢复之间的关系，以及其在有上肢运动功能缺损的中风患者中的随时间演变情况。
对16例患者在中风后3周、6周和12周测量了SLF I、SLF II和皮质脊髓束（CST）的分数各向异性（FA）值，以及通过上肢Fugl-Meyer评估评分和最大握力评估的上肢运动表现。使用重复测量的Friedman方差分析评估FA随时间的变化，并使用Spearman等级相关分析3周时CST、SLF I和SLF II的FA值与运动恢复、12周时的运动结果之间的相关性。
当通过上肢Fugl-Meyer评估进行评估时，3周时患侧半球的SLF I和SLF II的FA值与12周时的运动恢复相关（rho分别为0.502，p为0.04；rho为0.510，p为0.04），但通过握力评估时则不相关。SLF I和SLF II的FA值与运动结果不相关。患侧半球SLF II的FA值随时间有显著变化（p为0.016）。
SLF I和SLF II似乎都参与了中风后复杂运动的运动恢复，但不参与运动结果。这些结果表明，视觉/空间定向的运动任务以及使用顶叶联合区域的更复杂运动任务应用于中风后康复策略。
