Department of Physical Medicine and Rehabilitation, College of Medicine, Yeungnam University, Namku, Taegu, Republic of Korea.
Department of Physical Therapy, College of Health Sciences, Dankook University, Dongnamgu, Cheonan, Republic of Korea.
Medicine (Baltimore). 2023 Oct 13;102(41):e35510. doi: 10.1097/MD.0000000000035510.
In patients with intracerebral hemorrhage (ICH), the relationship between consciousness and the thalamocortical tract (TCT), which links the thalamic intralaminar nuclei (ILN) and the cerebral cortex, was investigated. Forty-one patients with ICH were assigned to 1 of 2 groups according to their preservation of consciousness as determined by their Glasgow coma scale (GCS) score. Patient group A had impaired consciousness (GCS < 15, 21 patients), and patient group B had intact consciousness (GCS = 15, 20 patients). The control group included 20 age- and sex-matched healthy subjects. For all groups, the TCTs from the thalamic ILN of both sides were reconstructed using a probabilistic tractography method based on a multifiber model. In addition, tract volume (TV) values were determined. The TV values for the ipsilateral TCT from the thalamic ILN of the all-patient groups and those for contralateral TCT of the patient group B showed no significant differences between ICH and contra-ICH sides (P > .05). The TV results for the ipsilateral and contralateral TCTs from the thalamic ILN of the ICH and contra-ICH sides were significantly different among the 3 groups (P < .05). Among the patients, there were moderate positive correlations between GCS scores and TV values of the ipsilateral TCT on the ICH and contra-ICH sides (R = 0.477, P < .05; R = 0.426, P < .05). The TV of the ipsilateral TCT from the thalamic ILN on the ICH and contra-ICH sides was significantly correlated with the consciousness level in patients with ICH. Our results could be helpful when developing therapeutic strategies for ICH patients with disorders of consciousness.
在脑出血(ICH)患者中,研究了连接丘脑内板核(ILN)和大脑皮层的丘脑皮质束(TCT)与意识之间的关系。根据格拉斯哥昏迷量表(GCS)评分,将 41 名 ICH 患者分为 2 组:意识保存组(GCS<15,21 例)和意识障碍组(GCS=15,20 例)。对照组包括 20 名年龄和性别匹配的健康受试者。对于所有组,使用基于多纤维模型的概率追踪方法重建双侧丘脑内板核的 TCT。此外,还确定了束流体积(TV)值。所有患者组的 TCT 同侧 TV 值和患者组 B 的 TCT 对侧 TV 值在 ICH 和 contra-ICH 侧之间无显著差异(P>0.05)。ICH 和 contra-ICH 侧的丘脑内板核的 TCT 同侧和对侧的 TV 值在 3 组之间有显著差异(P<0.05)。在患者中,GCS 评分与 ICH 和 contra-ICH 侧的 TCT 同侧 TV 值之间存在中度正相关(R=0.477,P<0.05;R=0.426,P<0.05)。丘脑内板核 TCT 同侧 TV 值与 ICH 患者的意识水平显著相关。我们的研究结果有助于制定意识障碍 ICH 患者的治疗策略。