A Prospective Of Proliferating Reorganization In Thalamic Radiation Fibers After Thalamic Infarction With Diffusion Tensor Imaging

Objective:Using diffusion tensor imaging(DTI)to dynamically observe the changes of the parameters of DTI in ipsilateral Infarcts adjacent area,corona radiate,centrum semiovale and contralateral thalamus,corona radiate,centrum semiovale after onset of thalamic infarction in our prospective study.Try to analyze the relationship of these datas and neuron functional recovery,and discuss its clinic significance.Method:Collecting 12 patients who was the first time suffered from the unilateral thalamic infarction and during within 7 days as the experiment group.12 healthy volunteers matched age and gender with the control group.Those patients were evaluated with the National Institutes of Health Stroke Scale(NIHSS),the Barthel Index(BI)and the sensory disturbance rating(SDR)to assess their loss of neuron function,and underwent DTI in first week,4 week,3 month and 6 month after stroke.All patients were assessed clinical outcomes by modified Rankin Scale(MRS)in 6 month after stroke.Volunteers underwent four times of DTI in the corresponding time.Results:(1)Compared with the control group,the FA values of the infarcts adjacent area are gradually increased over time,and significantly increased in 3 month(0.59 ± 0.07 vs 0.44 ± 0.09).The FA values of ipsilateral corona radiate and centrum semiovale are gradually increased over time,and significantly increased in 6 month(0.62±0.07 vs 0.55±0.05;0.54±0.08 vs 0.45±0.07).(2)Compared with the control group,the FA values of the contralateral thalamus are gradually increased over time,and significantly increased in 3 month(0.58 ±0.06 vs 0.44 ± 0.09).The FA values in contralateral corona radiate and centrum semiovale are gradually increased over time,and significantly increased in 6 month(0.62±0.05 vs 0.55±0.05;0.5210.06 vs 0.45±0.07).(3)The change of FA and MD values between ipsilateral and contralateral cerebral hemisphere have no statistical difference in 6 month.(4)NIHSS score and section 8 of NIHSS score for feeling(NIHSS8)gradually decreased over the time,but BI score and SDR score gradually increased(P<0.05).(5)The change of FA values in the infarcts adjacent area,ipsilateral corona radiate,ipsilateral centrum semiovale and the contralateral corona radiate and centrum semiovale with the change of NIHSS score,NIHSS8 score have positive correlation(p<0.05),but with the change of BI score and SDR score have negative correlation in partial correlation(p<0.05).Conclusion:(1)The Infarcts adjacent area,ipsilateral corona radiate and centrum semiovale and the contralateral thalamus,corona radiate and centrum semiovale will be occur of neural proliferating reorganization after stroke.(2)Neural proliferating reorganization may be the structure foundation of neural functional recovery.