右侧脑卒中的后期瘫痪:严重程度和持续时间的大脑解剖相关性

IF 2.6 3区 医学 Q2 CLINICAL NEUROLOGY
Journal of Neurologic Physical Therapy Pub Date : 2024-01-01 Epub Date: 2023-06-12 DOI:10.1097/NPT.0000000000000446
Elvira Salazar López, Carmen Krewer, Jeannine Bergmann, Ken Möhwald, Friedemann Müller, Klaus Jahn
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引用次数: 0

摘要

背景和目的:肢体后仰(Lateropulsion,LP)是一种严重的姿势控制障碍,对神经康复有重大影响。对相关脑区的了解可为决定适当的干预方法提供指导。尽管LP患者的LP严重程度和持续时间变化很大,但有关LP的成像研究并未充分考虑这些方面。本研究旨在调查脑卒中患者的病变位置以及与脑卒中持续时间和严重程度的相关性:方法:使用体素病灶症状映射(VLSM)对 74 例右侧脑损伤患者(49 例有 LP,25 例无 LP)进行回顾性病例对照研究,分析病灶位置与 LP 严重程度之间的相关性。对 22 名 LP 患者的持续时间进行了调查。LP 是通过逆推量表进行诊断的:结果:与无 LP 的人相比,有 LP 的人的病灶明显更大。对 LP 严重程度的 VLSM 分析未显示出具有统计学意义的结果。VLSM分析表明,额叶下回、海马、顶叶下回、边际上回、角回、颞叶皮层、矢状层和上纵筋膜与LP持续时间较长有统计学意义:LP相关区域位于多感觉网络中。研究发现,与空间认知、记忆和注意力有关的额顶叶网络区域与持续时间和严重程度相关。这些发现,尤其是涉及中颞皮层的持续时间方面的发现,可以解释为什么更多基于垂直度的隐性知识而非显性知识的方法能取得更好的干预效果。视频摘要可获得作者的更多见解(请参阅视频,补充数字内容1,网址:http://links.lww.com/JNPT/A433 )。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Lateropulsion in Right-Sided Stroke: Brain Anatomical Correlates of Severity and Duration.

Background and purpose: Lateropulsion (LP) is a profound disorder of postural control that has a significant impact on neurorehabilitation. Knowledge of relevant brain areas could guide decisions on appropriate intervention methods. Although LP severity and duration are highly variable in individuals with LP, imaging studies on LP have not sufficiently considered these aspects. The aim of this study was to investigate the lesion location in individuals after stroke and the correlation with LP duration and severity.

Methods: A retrospective case-control study using voxel lesion symptom mapping (VLSM) in 74 individuals with right-sided brain lesion (49 with and 25 without LP) was performed to analyze the correlation between lesion location and LP severity. Duration was investigated in a subsample of 22 individuals with LP. LP was diagnosed by means of the Scale for Contraversive Pushing.

Results: Individuals with LP showed significantly larger lesion sizes compared with the individuals with no LP. VLSM analysis of LP severity did not reveal statistically significant results. VLSM analysis showed a statistically significant association with longer LP duration for the inferior frontal gyrus, the hippocampus, the inferior parietal gyrus, the supramarginal gyrus, the angular gyrus, the temporal cortex, the sagittal stratum, and the superior longitudinal fasciculus.

Discussion and conclusion: LP-relevant areas are located in the multisensory network. Areas of the frontoparietal network, which are related to spatial cognition, memory, and attention, were found to be relevant for duration and severity. The findings, especially those regarding duration involving the middle temporal cortex, could explain the better intervention outcomes for methods based more on implicit than on explicit knowledge of verticality.Video Abstract available for more insights from the authors (see the Video, Supplemental Digital Content 1 available at: http://links.lww.com/JNPT/A433 ).

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来源期刊
Journal of Neurologic Physical Therapy
Journal of Neurologic Physical Therapy CLINICAL NEUROLOGY-REHABILITATION
CiteScore
5.70
自引率
2.60%
发文量
63
审稿时长
>12 weeks
期刊介绍: The Journal of Neurologic Physical Therapy (JNPT) is an indexed resource for dissemination of research-based evidence related to neurologic physical therapy intervention. High standards of quality are maintained through a rigorous, double-blinded, peer-review process and adherence to standards recommended by the International Committee of Medical Journal Editors. With an international editorial board made up of preeminent researchers and clinicians, JNPT publishes articles of global relevance for examination, evaluation, prognosis, intervention, and outcomes for individuals with movement deficits due to neurologic conditions. Through systematic reviews, research articles, case studies, and clinical perspectives, JNPT promotes the integration of evidence into theory, education, research, and practice of neurologic physical therapy, spanning the continuum from pathophysiology to societal participation.
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