中国神经再生研究(英文版) ›› 2021, Vol. 16 ›› Issue (5): 924-925.doi: 10.4103/1673-5374.297092

• 影像图片 • 上一篇    下一篇

弥漫性轴索损伤患者步态和损伤皮质网状脊髓束的恢复

  

  • 出版日期:2021-05-15 发布日期:2020-12-29

Recovery of gait and injured corticoreticulospinal tracts in a patient with diffuse axonal injury

Sung Ho Jang, You Sung Seo*   

  1. Department of Physical Medicine and Rehabilitation, College of Medicine, Yeungnam University, Daegu, Republic of Korea
  • Online:2021-05-15 Published:2020-12-29
  • Contact: You Sung Seo, MS, yousung1008@hanmail.net.

摘要:

弥散张量成像(DTI)可以借助对水分子扩散特征成像的能力来评估脑白质的完整性,具有检测弥漫性轴索损伤的独特优势。以往使用弥散张量成像的研究已证明皮质脊髓束,扣带和白质弥漫性轴索损伤的恢复。相比之下,迄今尚未见与步态相关的皮质网状脊髓束弥漫性轴索损伤恢复的研究。项研究报道了1例弥漫性轴索损伤患者,经弥散张量纤维束成像证实损伤的皮质网状脊髓束随步态的恢复而恢复。

患者23岁,男性,曾因车祸致头部创伤,被诊断为弥漫性轴索损伤。3个月后出现四肢瘫痪。患者经药物、物理治疗和作业疗法综合康复干预。腿部肌力在15个月内缓慢恢复,发病后18个月能够在平坦的地板上独立行走。

3个月的弥散张量纤维束成像显示左皮质网状脊髓束明显变窄,而右皮质网状脊髓束不连续。在18个月弥散张量纤维束成像显示,双侧皮质网状脊髓束均变粗,虽然皮质下白质的部分撕裂。

据作者所知,这是首次弥漫性轴索损伤后损伤皮质网状脊髓束恢复的弥散张量纤维束成像监测研究。

https://orcid.org/0000-0002-7480-3071 (You Sung Seo) 

Abstract: Diffuse axonal injury (DAI) is defined as the presence of microscopic axonal damage in the white matter of the brain produced by mechanical forces and is characterized histologically by widespread damage to axons (Maxwell et al., 1997). Diffusion tensor imaging (DTI) allows evaluation of the integrity of the white matter of brain to be determined by virtue of its ability to image water diffusion characteristics (Basser et al., 1994). Therefore, DTI has a unique advantage to detect DAI and many studies using DTI have investigated DAI (Wang et al., 2008). Furthermore, previous studies using DTI have demonstrated the recovery of DAI in the corticospinal tract, cingulum, and white matter (Kim et al., 2009; Edlow et al., 2016; Jang and Seo, 2016). There is no study on the recovery of DAI in the corticoreticulospinal tract (CRT) which is involved in gait function by innervating axial and leg muscles (Matsuyama et al., 2004).