Mochizuki Midori, Uchiyama Yuki, Domen Kazuhisa, Koyama Tetsuo
Department of Rehabilitation Medicine, Nishinomiya Kyoritsu Neurosurgical Hospital, Nishinomiya, Japan.
Department of Rehabilitation Medicine, School of Medicine, Hyogo Medical University, Nishinomiya, Japan.
Ann Rehabil Med. 2025 Feb;49(1):15-22. doi: 10.5535/arm.240073. Epub 2025 Feb 13.
To evaluate the association between outcomes, including affected extremity functions and activities of daily living (ADL), and fractional anisotropy (FA) derived from automated tractography incorporating age among patients after stroke.
This study enrolled stroke patients, and diffusion-tensor imaging was conducted during the second week. Standardized automated tractography was utilized to compute FA values in the corticospinal tract (CST), the inferior fronto-occipital fasciculus (IFOF), and the superior longitudinal fasciculus (SLF). Outcome evaluations were performed at discharge from our affiliated rehabilitation facility. Extremity functions were assessed using the total scores of the motor component of the Stroke Impairment Assessment Set (SIAS-motor). Independence levels in ADL were appraised through the motor and cognition components of the Functional Independence Measure (FIM). For each outcome measure, multivariate regression analysis incorporated the FA values of the CST, the IFOF, and the SLF, along with age.
Forty-two patients were enrolled in the final analytical database. Among the four explanatory variables, the CST emerged as the most influential factor for SIAS-motor scores. Conversely, age proved to be the primary determinant for both the motor and cognition components of FIM, surpassing the impact of FA metrics, including the CST and the IFOF.
The key influencing factors exhibited significant variations based on the targeted outcome assessments. Clinicians should be aware of these differences when utilizing neuroimaging techniques to predict stroke outcomes.
评估中风患者的结局（包括患侧肢体功能和日常生活活动能力（ADL））与通过纳入年龄的自动纤维束成像得出的分数 anisotropy（FA）之间的关联。
本研究纳入中风患者，并在第二周进行弥散张量成像。利用标准化自动纤维束成像计算皮质脊髓束（CST）、额枕下束（IFOF）和上纵束（SLF）中的FA值。在我们附属康复机构出院时进行结局评估。使用中风损伤评估量表（SIAS - 运动）运动部分的总分评估肢体功能。通过功能独立性测量（FIM）的运动和认知部分评估ADL的独立水平。对于每个结局指标，多变量回归分析纳入了CST、IFOF和SLF的FA值以及年龄。
42名患者被纳入最终分析数据库。在四个解释变量中，CST成为SIAS - 运动评分最具影响力的因素。相反，年龄被证明是FIM运动和认知部分的主要决定因素，超过了包括CST和IFOF在内的FA指标的影响。
关键影响因素根据目标结局评估显示出显著差异。临床医生在利用神经影像学技术预测中风结局时应意识到这些差异。
