脑卒中后神经网络损害与下肢步行功能结局的关系

目的:应用功能性磁共振(fMRI)研究脑卒中后神经网络受损情况,应用三维运动分析对比下肢步行功能改变结局的关系。方法:11例亚急性期脑梗死患者接受功能性磁共振(fMRI)的弥散张量成像(DTI)和扩散加权成像(DWI),并做三维步态检查,比较中枢神经损伤与肢体运动改变的关系。同时还应用量表对入组患者进行肢体运动功能、平衡及生存质量进行评估。结果:脑卒中患者皮质脊髓束皮质放射纤维部分各向异性(FA)值患侧明显小于健侧(P0.05),而表观扩散系数(ADC)两侧差异无显著性。脑卒中患侧FA值与患侧步时相关系数为0.615,存在正相关关系(P0.05)。运动功能结局的分析显示FA与步时相关。FA值与各项量表评分无明显相关性。结论:脑卒中后皮质脊髓束的受损可一定程度由FA值反映,对监测其病程有一定价值,而ADC结果则没有显著性意义。

The relationship between neural network damage and the gait function in lower limbs in patients post-stroke

AbstractObjective: To investigate the relationship between the damage of neural network poststroke from functional MRI(fMRI) analysis and the impact on the gait function from 3 dimensional(3D) motion analysis. Method: A total of 11 patients after subactue stroke were recruited in this study and examined with fMRI. In fMRI fraction anistrophy (FA) and apparent diffusion coefficient(ADC) were recorded. 3D-kinematic data of gait were also analyzed. The correlation coefficient between the neural functional damage and the gait changes was investigated. Clinical scales were used to evaluate the motor function,balance and quality of life of the recruited subjects. Result: FA of affected side was significantly lower than that of unaffected side. There was no significant difference in ADC value between the two sides. The correlation analysis showed that there was significant correlation between FA and step time of affected side. There was no significant correlation between FA and scores of function assessment scales. Conclusion: FA value of stroke patients could reflect the damage of corticospinal tract and might monitor the disease course post stroke in certain extent and the analysis of motor function outcome might be helpful to explain the motor recovery mechanism.