Research On Diffusion Tensor Imaging In Corticospinal Tract Injury And Long Dated Motor Function Recovery Of Patients With Subacute Cerebral Infarction

Objective： twenty-five cerebral infarction patients weredperformed by diffusion tensor imaging technology to investigate the degree ofinjury of corticospinal tracts in the front of posterior limb of internal capsule andcerebral peduncle, observe the position relation of the lesion and corticospinaltracts, analyse the long dated motor function recovery of subacute cerebralinfarction patients, to explore the application value of diffusion tensor imagingin the assessment of motor function prognosis of patients with subacute cerebralinfarction. Methods: collected twenty–five cases of subacute cerebralinfarction patients in the rehabilitation department of the people’s hospital ofSichuan province between June to september,2013. The patients all had the firstattack, unilateral lesion and different levels of motor dysfunction of unilaterallimbs.The lesion was located in the brain region that anterior circulation supplyblood. Twenty-five patients were performed magnetic resonance imaging anddiffusion tensor imaging ten days after cerebral infarction, then create the FAmaps, color FA maps, measure FA values in the front of posterior limb ofinternal capsule and cerebral peduncle and the corresponding region, calculatethe reduction percent of FA value of corticospinal tracts. The corticospinal tractsof both sides were rebuilt by diffusion tensor tractography. The patients were divided in to two group, according to the position relationship between thelesion and corticospinal tracts. A group (corticospinal tracts partly or whollyacross the lesion)，B group (corticospinal tracts not across the lesion). Thepatients accepted rehabilitation therapy according to the standard operatingprocedure in the hospital, then evaluated the motor function of the patients bysimple Fugl-Meyer scale ten days、three months or six months after cerebralinfarction. We compared the motor function scores at different times betweentwo groups; observed the change of motor function scores of each group indifferent times; analysed the relationship between the reduction percent of FAvalue in ipsilateral cerebral peduncle and the front of posterior limb of internalcapsule and motor function scores ten days、three months or six month aftercerebral infarction. Results: The FA maps showed good and clear and thecorticospinal tracts was reconstructured well. The corticospinal tract pass thoughthe front of posterior limb of internal capule, project to precentral gyrus,paracentral lobule, frontal and parietal lobe partly. sixteen patients’ ipsilateralcorticospinal tracts partly or wholly passed though the lesion, While nineteenpatients not. The FA values in the front of ipsilateral posterior limb of internalcapsule and cerebral peduncle decreased compared with the correspondingcontralateral areas ten days after cerebral infarction, and the difference wasstatistically significant(p<0.05)；The reduction percent of FA value in the frontof posterior limb of internal capsule and cerebral peduncle that corticospinaltracts partly or wholly crossing the lesion was significantly greater than the corticospinal tracts not crossing the lesion (p<0.05)；The simple Fugl-Meyerscores of the two group patients that corticospinal tracts not acrossing the lesionand partly or wholly acrossing the lesion had statistically differences ten days,three months or six months after cerebral infarction (p<0.05); The motorfunction scores evaluated ten days and three months after cerebral infarction hadstatistical difference in the group corticospinal tracts not crossing the lesion, butno statistical difference evaluated six months or three months(p>0.05). Themotor function scores evaluated ten days,3months and6months after cerebralinfarction all had significant statistical difference in the group corticospinaltracts pass though the lesion partly or wholly(p<0.05); The reduction percent ofFA value of twenty-five patients in the front of posterior limb of internal capsuleand cerebral peduncle measured ten days after cerebral infarction correlatednegatively with the motor function scores evaluated three months or six monthsafter cerebral infarction(p<0.05); The reduction percent of FA value in the frontof posterior limb of internal capsule correlated negatively with the motorfunction scores evaluated three months or six months after cerebral infarction inthe group corticospinal tracts pass though the lesion partly or wholly, but nocorrelation was founded between the reduction percent of FA value in cerebralpeduncle and the motor function scores evaluated three months or six monthsafter cerebral infarction.Conclutions：The reduction percent of FA value of posterior limb of internalcapsule and cerebral peduncle in group corticospinal tracts pass though the lesion partly or wholly is greater than corticospinal tracts no pass though thelesion. The reduction percent of FA value of posterior limb of internal capsuleand cerebral peduncle evaluated the days after cerebral ischemia, the positionrelationship of lesion and corticospinal tracts could predict long-dated motorfunction recovery. For the group corticospinal tracts pass though the lesionpartly or wholly, the reduction percent of FA values in the front of ispilateralposterior limb of internal capule could possibly predict long-dated motorfunction recovery better.