Abstract

Objectives

We investigated the characteristics of prefronto-thalamic tract (PF-TT) injuries in stroke patients using diffusion tensor tractography (DTT) and assessing cognitive outcome according to location of the external ventricular drainage (EVD).

Methods

Forty-five consecutive stroke patients who underwent EVD and 24 control subjects were recruited. The patients were classified into three groups: group A (EVD on the lesion or one side, 17 patients), group B (EVD on the hemisphere opposite to the lesion, 12 patients), and group C (EVD on both sides, 16 patients). Mini-Mental State Examination (MMSE) results were performed at the beginning (average 2.27 months from onset) and end (average 4.19 months from onset) of rehabilitation. Three parts of the PF-TT (dorsolateral PF-TT[DLPF-TT], ventrolateral PF-TT[VLPF-TT], orbitofronto-thalamic tract[OF-TT]) were reconstructed and the fractional anisotropy (FA) and tract volume (TV) measurements were obtained.

Results

With the EVD on the stroke-affected side, the values of FA and TV of all three parts of the PF-TTs in three patient groups were lower than those of the control group (p < 0.05). With the EVD on the unaffected side, the FA values of the DLPF-TT in groups B and C and the OF-TT in group C were lower than those of the control group (p < 0.05). There was no difference in initial MMSE score among three patient groups; however, group A had a higher mean follow-up MMSE score than that of groups B and C (p < 0.05).

Conclusions

Patients who underwent EVD of the affected hemisphere showed better results in terms of the PF-TT injury and cognitive outcome than patients who underwent EVD through the unaffected hemisphere or through both hemispheres.

中文翻译：

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脑室外引流位置对脑卒中患者前额丘脑束损伤及认知结局的影响

摘要

目标

我们使用弥散张量束成像 (DTT) 调查了中风患者前额丘脑束 (PF-TT) 损伤的特征，并根据脑室外引流 (EVD) 的位置评估认知结果。

方法

招募了 45 名接受 EVD 的连续中风患者和 24 名对照受试者。将患者分为三组：A组（病灶或一侧EVD，17例）、B组（病灶对侧半球EVD，12例）、C组（双侧EVD，16例） ）。简易精神状态检查 (MMSE) 结果在康复开始（平均 2.27 个月）和结束（平均 4.19 个月）进行康复。重建 PF-TT 的三个部分（背外侧 PF-TT[DLPF-TT]、腹外侧 PF-TT[VLPF-TT]、眶额丘脑束[OF-TT]），并重建分数各向异性（FA）和束体积(TV) 测量值已获得。

结果

脑卒中患侧EVD，三组患者PF-TTs三部分的FA和TV值均低于对照组（p  <0.05）。在健侧EVD的情况下，B、C组DLPF-TT和C组OF-TT的FA值均低于对照组（p  <0.05）。三个患者组的初始 MMSE 评分没有差异；然而，A 组的平均随访 MMSE 评分高于 B 组和 C 组（p  < 0.05）。

结论

在受累半球接受 EVD 的患者在 PF-TT 损伤和认知结果方面显示出比通过未受影响的半球或通过两个半球接受 EVD 的患者更好的结果。