缺血性卒中脑类淋巴系统功能受损与运动功能障碍的相关性研究  

Study on the correlation between cerebral glymphatic system dysfunction and motor dysfunction in patient with ischemic stroke

作　　者：田娟 李馨 李笑石 钱一帆 高小华 王磊 秦越 TIAN Juan;LI Xin;LI Xiaoshi;QIAN Yifan;GAO Xiaohua;WANG Lei;QIN Yue(Department of Imaging,Xi’an Daxing Hospital,Xi’an 710016,China)

机构地区：[1]西安大兴医院影像科,陕西西安710016

出　　处：《实用放射学杂志》2023年第12期1922-1925,共4页Journal of Practical Radiology

基　　金：陕西省重点研发计划项目(S2023-YF-YBSF-1496)。

摘　　要：目的探讨运动功能障碍的缺血性卒中(IS)患者卒中后脑类淋巴系统的活性及其与运动功能评分、皮质脊髓束(CST)完整性之间的关系。方法招募20例IS患者(卒中组)和健康志愿者(对照组)20例。卒中组均为左侧大脑半球皮质下单发病灶。记录所有受试者的人口学数据和临床量表资料。所有受试者行颅脑MRI扫描,序列包括扩散张量成像(DTI)和T2WI。计算侧脑室水平血管周围间隙扩散张量成像分析(DTI-ALPS)指数、CST各向异性分数(FA)及轴向扩散系数(AD)并比较2组间各指标差异。分析卒中组DTI-ALPS指数与Fugl-Meyer评分、CST完整性之间的相关性。结果卒中组患侧DTI-ALPS指数明显低于对照组同侧(t=-3.88,P<0.001);卒中组患侧DTI-ALPS指数与运动功能评分(P=0.019)、运动功能评分分级(P=0.024)和感觉评分(P=0.048)均呈正相关,且与健侧CST的FA(r=-0.60,P=0.009)、AD(r=-0.67,P=0.002)呈负相关。结论IS患者的DTI-ALPS指数降低提示其脑类淋巴系统受损。DTI-ALPS指数可能成为IS患者运动功能障碍的潜在MRI影像学指标,同时对IS病理生理机制的研究提出了新的思路。Objective To evaluate the activity of the cerebral glymphatic system during recovery in ischemic stroke(IS)patients with motor dysfunction,and to explore its association with motor function scores and corticospinal tract(CST)integrity via.Methods A total of 20 patients with IS(stroke group)and 20 healthy volunteer(control group)were recruited.There was a single lesion located at the left cerebral hemisphere in the stroke group.Demographic and clinical data of all participants were recorded.All participants underwent brain MRI scans,including diffusion tensor imaging(DTI)and T2WI.Diffusion tensor image analysis along the perivascular space(DTI-ALPS)index at lateral ventricle level,fractional anisotropy(FA)and axial diffusivity(AD)of CST were calculated and the differences of each index between the two groups were compared.The correlation between DTI-ALPS index and Fugl-Meyer score and integrity of CST were analyzed in stroke group,respectively.Results The DTI-ALPS index in the stroke group was significantly lower than that in the control group(t=-3.88,P<0.001).The DTI-ALPS index in the stroke group was positively correlated with motor function score(P=0.019),motor function grading(P=0.024)and sensory score(P=0.048),respectively.The DTI-ALPS index was negatively correlated with FA(r=-0.60,P=0.009)and AD(r=-0.67,P=0.002)of healthy side CST.Conclusion The decrease of DTI-ALPS index in patients with IS indicates the damage of cerebral glymphatic system.DTI-ALPS index may be a potential MRI biomarker for motor dysfunction in patients with IS,and a new idea is proposed for the study of the pathophysiological mechanism of IS.

关 键 词：脑类淋巴系统 缺血性卒中 运动功能障碍 扩散张量成像 

分 类 号：R743[医药卫生—神经病学与精神病学] R445.2[医药卫生—临床医学]