A Study of Wallerian Degeneration in Cortico Spinal Tract after Cerebral Infarction by fMRI
|School||Zunyi Medical College,|
|Course||Medical Imaging and Nuclear Medicine|
|Keywords||cerebtal infarction acupuncture wallerian degeneration functional magnetic resonance imaging diffusion tensor imaging|
Objective:To investigate the development of wallerian degeneration after cerebral infarction by DT、MRS.To evaluate the relation between wallerian degeneration and motor recovery of stroke patients and try to guide the prognosis.Metheds:Patients with a recent unilateral cerebral infarction were chosed, male 16, female10, age31-78,mean age61.5; Volunteers were chosed, male 18,female 12,age 19-72,mean age 55.9. There were no significant differences between groups on gender and age (P>0.05) The volunteers were performed Serial DTI and MRS scans for one time.The patients were performed Serial DTI,FLAIR and T2WI(TRA、SAG、COR) scans for four times which were on 1W、1M、3M and 6M. In addition,the NIHSS and BI were measured during each time.FA、ADC and MRS were examined at infarction area and cerebral peduncle.The correlation was analysed between FA、NAA、CST and NS function.All data showed with xs. P<0.05 as significant difference.Results:(1) The FA at infarction was decreased in all patient.lt has positive correlation with BI and negative correlation with NIHSS.This suggest CST broke more,NS function recovery less. There was a significant decrease on FA in braintem in braintem than the contralateral,which suggest WD developed in braintem. The ADC at infarction is statistically significant than the contralateral. The ADC at cerebral peduncle is not statistically significant than the contralateral.(2) The NAA at infarction was decreased to different extent than the contralateral in all patient.NAA:The lesions side with the contralateral part comparison, P<0.01;Cr、Cho: The lesions side with the contralateral part comparison, P>0.05; The NAA did not change in first week but deceasesed in first month.This suggest wallerian degeneration developed in cerebral peduncle.(3)While CST was close to infarction,the function can recovery to normal;part of CST cross from infarction,the patient may has mild to moderate dysfunction;all CST cross from infarction,the patient may has moderate to severe dysfunction.Conclusion:According to the change of ADC、FA、MRS, the severity of condition can be reflected、WD be detected early、the progressive be judge and the recovery be suggested.