Chinese General Practice ›› 2023, Vol. 26 ›› Issue (32): 4098-4102.DOI: 10.12114/j.issn.1007-9572.2023.0152

• Review & Perspectives • Previous Articles    

Advances in the Prognostic Value of Diffusion Tensor Imaging with Motor Evoked Potential for Motor Function in Cerebral Infarction Patients with Hemiplegia

  

  1. 1. The Fifth Clinical Medical College of Shanxi Medical University, Taiyuan 030000, China
    2. Shanxi Inheritance Studio of Renowned Senior TCM Physician ZHAO Furun, Taiyuan 030000, China
    3. Shanxi University of Chinese Medicine, Taiyuan 030000, China
    4. Department of Neurology, Shanxi Provincial People's Hospital, Taiyuan 030000, China
  • Received:2023-03-05 Revised:2023-04-10 Published:2023-11-15 Online:2023-04-20
  • Contact: ZHAO Xiaoxia

弥散张量成像联合运动诱发电位评估脑梗死偏瘫患者运动功能预后价值的研究进展

  

  1. 1.030000 山西省太原市,山西医科大学第五临床医学院
    2.030000 山西省太原市,山西省赵福润名老中医传承工作室
    3.030000 山西省太原市,山西中医药大学
    4.030000 山西省太原市,山西省人民医院神经内科
  • 通讯作者: 赵晓霞
  • 作者简介:
    作者贡献:孟江涛负责文献资料的收集、整理、文章整体构思、论文撰写;杨思宇、孙蕾、雷瑞宁负责文献资料整理;赵晓霞提出研究思路、负责论文修订、文章质量控制,对文章负责。
  • 基金资助:
    山西省重点研发计划(201703D321017-3)

Abstract:

Limb paralysis is a common sequela of cerebral infarction, which leads to both physical disorders and heavy psychological burden. Recent years have witnessed growing studies on the prognosis of motor function in patients with cerebral infarction, and increasing well-known relevant medical evaluation tools, such as diffusion tensor imaging (DTI) and motor evoked potential induced by transcranial magnetic stimulation (TMS-MEP), which can microscopically assess the structural changes in white matter fiber bundles, and the combined use of them, that is, the combination of neuroanatomy, electrophysiology and neuroimaging, can more accurately assess the level of motor neuron impairment, thereby obtaining a motor function assessment surpassing the assessment based on clinical function indicators in terms of objectivity. We reviewed the prognostic value of DTI and TMS for motor function recovery via detecting and quantifying corticospinal tract degeneration in patients after cerebral infarction, and summarized the prognostic values of commonly used relevant measurement parameters for motor function recovery in hemiplegic patients. We concluded that DTI and TMS-MEP are powerful tools for noninvasively assessing complex structures of brain tissues, which can detect more subtle neural and tissue changes, and the combined use of them can effectively explore the damage pattern of white matter fiber bundles using different analysis methods, contributing to the development of neurological rehabilitation programs and maximum improvement of the long-term prognosis for patients.

Key words: Brain infarction, Diffusion tensor imaging, Transcranial magnetic stimulation, Prognosis of motor function, Neurological rehabilitation, Review

摘要:

肢体瘫痪是脑梗死常见的后遗症,给患者带来躯体障碍的同时还带来沉重的心理负担。近年来对于脑梗死患者运动功能预后的研究日益增多,越来越多的医学评估工具被大家熟知,磁共振弥散张量成像(DTI)及经颅磁刺激运动诱发电位(TMS-MEP)可以从微观上探查患者白质纤维束结构的变化,将DTI和TMS-MEP联合即神经解剖及电生理学和神经影像学的联合,能更加精准地反映运动神经元损害程度,得到比临床功能指标更加客观的运动功能评估。本文基于DTI及经颅磁刺激(TMS)在皮质脊髓束中的作用对脑梗死后患者运动功能恢复的预测评估做一综述,概括DTI及TMS常用测量参数在偏瘫患者运动功能恢复评估中的价值,得出了DTI及TMS-MEP可以发现更为细微的神经及组织变化,是无创探索复杂脑组织结构的有力工具,通过DTI和TMS的联合,利用不同的分析方法有效探索白质纤维束的损伤模式,将有助于为患者制订相应的神经功能康复方案,最大限度地改善患者的远期预后。

关键词: 脑梗死, 弥散张量成像, 经颅磁刺激, 运动功能预后, 神经康复, 综述