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首页> 外文期刊>Cerebrovascular diseases >Cerebral network disruption as a possible mechanism for impaired recovery after acute pontine stroke.
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Cerebral network disruption as a possible mechanism for impaired recovery after acute pontine stroke.

机译：脑网络破坏是急性脑桥卒中后恢复受损的可能机制。

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BACKGROUND: Recovery from stroke is presumed to be a function of a widespread cerebral network. Chronic white matter lesions (WML) have been proposed to be a predictor of poor outcome after acute stroke. We tested the hypothesis that the extent of WML has an effect on functional recovery in acute pontine stroke by disrupting the integrity of the supratentorial cerebral network. METHODS: Seventeen patients with acute unilateral pontine stroke who had received a standardized stroke workup and additional diffusion tensor imaging (DTI) were studied. After grading the extent of WML according to the Fazekas scale and semiautomated lesion volume calculation, we compared patients with acute pontine infarction and advanced WML to those with absent or minimal WML regarding baseline characteristics, stroke subtype and clinical outcome. In addition, we used tract-based spatial statistics for voxel-wise analysis of the DTI-derived parameter fractional anisotropy in the white matter tracts. RESULTS: The volume of WML ranged between 0.1 and 42.1 cm(3) (mean = 15.9) and was graded as follows: 0 in 5.9%, 1 in 35.3%, 2 in 41.2% and 3 in 17.6%. Both patients with Fazekas grades 2-3 (p = 0.014) as well as those with larger WML volumes (p = 0.037) had severer functional deficits at the 3-month follow-up. White matter tracts displaying a significant decrease in fractional anisotropy values were the corpus callosum, the anterior thalamic radiation and the inferior fronto-occipital fasciculus. CONCLUSIONS: Chronic WML contribute to a less favorable clinical outcome after pontine stroke depending on (1) the extent of pre-existing WML and (2) the degree of disruption of cerebral connectivity as indicated by reduced tissue integrity in the white matter not affected by WML as detected by DTI and tract-based spatial statistics.
机译：背景：卒中恢复被认为是广泛的大脑网络的功能。慢性白质病变（WML）已被认为是急性中风后预后不良的指标。我们测试了以下假设：WML的程度通过破坏上皮上脑网络的完整性而对急性桥脑中风的功能恢复产生影响。方法：对17例急性单侧桥脑卒中患者进行了标准的卒中检查和额外的弥散张量成像（DTI）。根据Fazekas量表和半自动病变体积计算对WML的程度进行分级后，我们将基线状态，中风亚型和临床结局的急性桥脑梗死和晚期WML患者与WML缺乏或极少的患者进行了比较。另外，我们使用基于区域的空间统计数据对白质区域中DTI派生的参数分数各向异性进行体素分析。结果：WML的体积在0.1到42.1 cm（3）之间（平均= 15.9），并按以下等级分级：0占5.9％，1占35.3％，2占41.2％和3占17.6％。 Fazekas 2-3级（​​p = 0.014）以及WML量较大（p = 0.037）的患者在3个月的随访中均出现严重的功能缺陷。显示出分数各向异性值显着降低的白质束是were体，丘脑前部辐射和额枕下筋膜下部。结论：慢性WML导致脑桥卒中后临床效果较差，这取决于（1）既往WML的程度和（2）受不受影响的白质组织完整性降低所表明的脑连通性破坏程度。由DTI和基于区域的空间统计数据检测到的WML。

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