闭锁综合征患者运动诱发电位和皮质脊髓束弥散张量成像变化

目的：应用弥散张量成像（DTI）技术和运动诱发电位（MEP）评估闭锁综合征患者皮质脊髓束（CST）运动功能,观察DTI与MEP变化与运动功能的关系.方法：对2例脑干卒中患者分别于入院时、入院后2周进行DTI及MEP动态观察,测定患侧CST的部分各向异性值（FAV）,观察内囊纤维成像和MEP变化及其与运动功能的关系.结果：入院时DTI显示CST的FAV降低,通过脑干的下行白质纤维明显减少,入院2周后FAV和白质纤维均增加;入院时MEP的皮质电位消失,但是2周后随着FAV增加,皮质MEP重新出现,患者的运动功能也开始好转.结论：DTI的变化与MEP关系密切,它们与运动功能呈正相关.

Changes of diffusion tensor images and motor evoked potential in patients with locked-in syndrome

Objective：To observe the changes of eortieospinal tract（CST） function changes by diffusion tensor images（DTI） and motor evoked potential （MEP）as well as the relationship betwen DTI and MEP changes and motor function. Methods：DTI and MEP of two patients with sudden weakness of four extremities and inability of speech were observed on admission to hospital and two weeks after admission. Brain CT showed hypodensity in the ventral part of the upper brainstem in one case, and hyperdensity in the same area in another one. The diagnosis of locked-in syndrome was conformed by neuroimaging and clinical data. The muscle power was also determined. Results： DTI showed that fractional anisotropy values （FAV） were decreased and the white fibers descending as the brainstem reduced significantly on admission. Both FAV and the white fibers increased and motor function was improved two weeks after admission. Cortical potential of MEP was absent on admission, and it was observed two weeks later with the increase of FAV. Conclusion：The changes of DTI are associated with MEP. They ane positively correlated with the motor function.