Applications of Diffusion Tensor MRI to Predict Motor Recovery of Stroke Patients in the Chronic Stages
3
조회
0
다운로드
0
인용
0
참고문헌
키워드
초록
Within 2 to 5 months after stroke, patients recover variable degrees of function, depending on the initial deficit. An impaired hand function is one of the most serious disability in chronic stroke patients. Therefore, to evaluate the extent of motor dysfunction in the hemiplegic hand is important in stroke rehabilitation.In this paper, motor recoveries in 8 chronic stroke patients with Fugl-Meyer (FM) and white matter changes before and after the training program with a designed bilateral symmetrical arm trainer (BSAT) system were examined. The training was performed at 1 hr/day, 5 days/week during 6 weeks. In all patients, FM was significantly improved after the 6-week training. Diffusion tensor imaging (DTI) results showed that fractional anisotropy ratio (FAR) and fiber tracking ratio (FTR) in the posterior internal capsule were significantly increased after the training. It seemed that the cortical reorganization was induced by the 6 week training with the BSAT. In all parameters proposed this study, a significant correlation was found between these parameters (FAR and FTR) and motor recoveries. This study demonstrated that DTI technique could be useful in predicting motor recovery in chronic hemiparetic patients.
Abstract
Within 2 to 5 months after stroke, patients recover variable degrees of function, depending on the initial deficit. An impaired hand function is one of the most serious disability in chronic stroke patients. Therefore, to evaluate the extent of motor dysfunction in the hemiplegic hand is important in stroke rehabilitation.In this paper, motor recoveries in 8 chronic stroke patients with Fugl-Meyer (FM) and white matter changes before and after the training program with a designed bilateral symmetrical arm trainer (BSAT) system were examined. The training was performed at 1 hr/day, 5 days/week during 6 weeks. In all patients, FM was significantly improved after the 6-week training. Diffusion tensor imaging (DTI) results showed that fractional anisotropy ratio (FAR) and fiber tracking ratio (FTR) in the posterior internal capsule were significantly increased after the training. It seemed that the cortical reorganization was induced by the 6 week training with the BSAT. In all parameters proposed this study, a significant correlation was found between these parameters (FAR and FTR) and motor recoveries. This study demonstrated that DTI technique could be useful in predicting motor recovery in chronic hemiparetic patients.
참고문헌 (22)
- E.B.Murray and V, "Stroke Rehabilitation", pp.34~36 (1987), NY, USA: Williams & Wilkins
- S.J. Fellows, "Agonist and antagonist EMG activation during isometric torque development at the elbow in spastic hemiparesis", Electroencephal Clin Neurophsiol, 93, pp.106~112 (1994)
- J. Whitall, "Repetitive bilateral arm training with rhythmic auditory cueing improves motor function in chronic hemiparetic stroke", Stroke, 31, pp.2390~2395 (2000)
- C.Beulieu, "The basis of anisotropy water diffusion in the nervous system-a technical review", NMR Biomed, 15, pp.435~455 (2002)
- D. Le Bihan, "Diffusion tensor imaging: conceps and applications", J Magn Reson Imaging, 13, pp.534~536 (2001)
- C.H.Sotak, "The role of diffusion tensor imaging in the evaluation of ischemic brain injury-a review", NMR Biomed, 15, pp.561~569 (2002)
- D.J. Werring, "Diffusion tensor imaging can detect and quantify corticospinal tract degeneration after stroke", J Neurol Neurosurg Phychiatry, 69, pp.269~272 (2000)
- K.S. Tae, "Diffusion Tensor Imaging in Patients with Thalamic Hemorrhage:Correlations between Diffusion Anisotropy and Motor Recovery", Key Eng. Materials, 326, pp.895~898 (2006)
- E.R. Melhem, "Diffusion tensor MR imaging of the brain and white matter tractography", Am J Roentgenol, 178, pp.3~16 (2002)
- A.G. Sorensen, "Human acute cerebral ishchemia: detection of changes in water diffusion anisotropy by using MR imaging", Radiology, 212, pp.785~792 (1991)
- J.S. Shimony, "Quantitative diffusion tensor anisotropy brain MR imaging: human data and anatomic analysis", Radiology, 212, pp.770~784 (1999)
- P.W. Ducan, "Reliability of the Fugl-Meyer assessment of sensorimotor recovery following cerebrovascular accident", Phys Ther, 63, pp.1606~1610 (1983)
- S. Mori, "Imaging cortical association tracts in the human brain using diffusion-tensor-based axonal tracking", Magn. Reson. Med, 47, pp.213~215 (2002)
- A. Kunimatsu, "The optimal trakability threshold of fractioanl anisotropy for diffusion tendor tractography of the corticospinal tract", Magn. Reson. Med. Sci, 3, pp.11~17 (2004)
- U.C. Wieshmann, "Anisotropy of water diffusion in corona radiata and cerebral peduncle in patients with hemiparesis", Neuroimage, 10, pp.225~230 (1999)
- T. Watanabe, "Three-dimensional anisotropy contrast magnetic resonance axonography to predict the prognosis for motor function in patients suffering from stroke", J Neurosurg, 94, pp.955~960 (2001)
- Q. Yang, "Serial study of apparent diffusion coefficient and anisotropy in patients with acute stroke", Stroke, 30, pp.2382~2390 (1999)
- V.J. Schmithost, "Differences in white matter architecture between musicians and non-musicians: a diffusion tensor imaging study", Neurosci Lett, 321, pp.57~60 (2002)
- S.H. Jang, "Diffusion anisotropy in the early stages of stroke can predict motor outcome", Rest Neurol and Neurosci, 23, pp.11~17 (2005)
- H.C. Cho, "Analysis of corticospinal tract injury by using the diffusion tensor imaging of 3.0T magnetic resonance in patients with hypertensive intracerebral hemorhage", J Korean Neurosur Soc, 38, pp.331~337 (2005)
- S. Mori, "Brain white matter anatomy of tumor patients evaluated with diffusion tensor imaging", Ann Neurol, 5, pp.377~380 (2002)
- A. Kunimatsu, "Three-dimensional white matter tractography by diffusion tensor imaging in ischemic stroke involving the corticospinal tract", Diagnostic Neurol, 45, pp.532~535 (2003)
