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目的研究卒中偏瘫患者脑白质结构的损伤程度,并探讨脑白质损伤与运动功能障碍的相关性。方法对17例卒中偏瘫患者和21例健康对照进行大脑DTI数据扫描,应用TBSS方法对两组被试的部分各项异性(FA)、轴向弥散系数(λ_1)、径向弥散系数(λ23)进行统计分析;通过约翰霍普金斯白质分区图谱提取卒中患者组的感兴趣区域,并与上肢肢体运动功能评分进行相关分析。结果卒中患者在患侧皮质脊髓束、额枕下束、钩束、丘脑前辐射、上纵束、胼胝体额部和双侧胼胝体枕部的FA值显著降低(P<0.005);患侧皮质脊髓束的λ_1值也显著降低(P<0.05),患侧皮质脊髓束、额枕下束、钩束、丘脑前辐射、胼胝体额部以及双侧上纵束、胼胝体枕部的λ_(23)值显著升高(P<0.01)。患侧皮质脊髓束的λ_1值与上肢Fugl-Meyer运动功能评分存在显著正相关(P<0.05)。结论卒中患者脑白质纤维束的结构完整性有明显损伤,患侧皮质脊髓束的λ_1值可以反映卒中患者运动功能障碍的程度。
Objective To study the degree of white matter damage in patients with hemiplegia after stroke and to explore the correlation between white matter damage and motor dysfunction. Methods 17 cases of stroke hemiplegia patients and 21 healthy controls were scanned by DTI data of brain. TESS method was used to analyze the partial anisotropy (FA), axial diffusion coefficient (λ_1), radial diffusion coefficient (λ23) Statistical analysis was carried out. Region of interest of stroke patients was extracted from Johns Hopkins white matter zonation map and correlation analysis was made with motor function scores of upper limbs. Results The FA value of patients with stroke was significantly lower in the ipsilateral corticospinal tract, frontal suboccipitous bundle, hook bundle, pre-thalamic radiation, superior longitudinal bundle, frontal part of the corpus callosum and bilateral corpus callosum occipital part (P <0.005) The λ_1 value of the bundle was significantly lower (P <0.05). The value of λ_ (23) in the ipsilateral corticospinal tract, the frontal suboccipitous bundle, the hook bundle, the thalamic frontal radiation, the frontal part of the corpus callosum and the bilateral superior longitudinal bundles and the corpus callosum Significantly increased (P <0.01). There was a significant positive correlation between λ_1 value of ipsilateral corticospinal tract and Fugl-Meyer motor function score of upper limb (P <0.05). Conclusion The structural integrity of cerebral white matter fiber bundles in stroke patients is obviously damaged. The λ_1 value of ipsilateral corticospinal tract can reflect the degree of motor dysfunction in stroke patients.