Study On The Relationship Between CST And Motor Functions And The Effect Of Electroacupuncture To CST Of Hemiplegic Patients With Intracerebral Hemorrhage In Basal Ganglia

Objective: To investigate the relationship between corticospinal tract (CST) and motor functions and the effect of electroacupuncture to CST of hemiplegic patients with intracerebral hemorrhage in basal ganglia by using diffusion tensor imaging (DTI).Methods:61 hemiplegic patients with intracerebral hemorrhage in basal ganglia without surgical intervention were recruited, age from 30 to 85 years (59.05±11.74 years), the volume of hematoma from 8.3ml to 30ml (18.18±6.77ml). All the subjects were randomly divided into group A (rehabilitation group, 31 patients) and group B (electroacupuncture plus rehabilitation group, 30 patients). All the patients performed DTI examination and evaluation of motor functions within 1 week after onset and 4 weeks later. The CST was classified into 5 grades:grade 1, complete CST; grade 2, complete CST but displacement; grade 3, less than 1/2 CST ruptured; grade 4, more than 1/2 CST ruptured; grade 5, CST complete ruptured. Motor functions were evaluated by Barthel index (BI), muscle strength grades, the criteria for evaluation of curative effect for wind-stroke. The first and second CST grades and the data of evaluation of motor functions were compared to analyze the relationship between the changes of CST and motor recovery. The first and second CST grades and the data of evaluation of motor functions were compared between group A and B to analyze the effect of electroacupunctue to CST.Results:The first and second CST grades had significant negative correlation with the first and second BI scores (r= - 0.896, r= - 0.836), significant positive correlation with wind-stroke scores(r=0.906, r=0.865), significant negative correlation with muscle strength grades (r= - 0.906, r= - 0.865), all the P<0.05. The higher the CST grades classified, the poorer the motor functions evaluated (P<0.05). The higher the first CST grades classified, the poorer the motor functions evaluated 1 month later (P<0.05). The second data of evaluation of motor functions of group B were better than group A (P<0.01) and the rangeability of evaluation scores were bigger than group A (P<0.01). The second data of evaluation of motor functions of patients got CST grade 4 in the first DTI examination in group B were better than the patients in group A (P<0.01) and the rangeability of evaluation scores were also bigger (P<0.01).Conclusion: We conclude that the grades of CST can reflect the injury of motor functions in hemiplegic patients with intracerebral hemorrhage in basal ganglia, the volume of hematoma is less than 30ml. The higher the CST grades classified, the worse the motor functions injured. The CST grades classified within 1 week after onset can predict the motor functions 1 month later. Electroacupuncture plus rehabilitation treatment is better than rehabilitation treatment in CST restoring and motor functions recovering, especially for the patients got CST grade 4 in the first DTI examination within 1 week after onset.