Abstract:
The concept of brain reserve capacity positively influencing the process of recovery after stroke has been continuously developed in recent years. Global measures of brain health have been linked with a favourable outcome. Numerous studies have evidenced that the cerebellum is involved in recovery after stroke. However, it remains an open question whether characteristics of cerebellar anatomy, quantified directly after stroke, might have an impact on subsequent outcome after stroke. Thirty-nine first-ever ischaemic non-cerebellar stroke patients underwent MRI brain imaging early after stroke and longitudinal clinical follow-up. Structural images were used for volumetric analyses of distinct cerebellar regions. Ordinal logistic regression analyses were conducted to associate cerebellar volumes with functional outcome 3-6 months after stroke, operationalized by the modified Rankin Scale. Larger volumes of cerebellar lobules IV, VI, and VIIIB were positively correlated with favourable outcome, independent of the severity of initial impairment, age, and lesion volume (P < 0.01). The total cerebellar volume did not exhibit a significant structure-outcome association. The present study reveals that pre-stroke anatomy of distinct cerebellar lobules involved in motor and cognitive functioning might be linked to outcome after acute non-cerebellar stroke, thereby promoting the emerging concepts of structural brain reserve for recovery processes after stroke.
摘要:
近年来,大脑储备能力的概念对中风后的恢复过程产生了积极影响。全球大脑健康指标与有利的结果有关。许多研究已经证明小脑参与中风后的恢复。然而,小脑解剖学的特征,中风后直接量化,可能会对卒中后的预后产生影响.39例首次缺血性非小脑卒中患者在卒中后早期接受了MRI脑成像和纵向临床随访。结构图像用于不同小脑区域的体积分析。进行有序logistic回归分析,将小脑体积与卒中后3-6个月的功能结局相关联。通过修改后的Rankin量表进行操作。较大体积的小脑小叶IV,VI,和VIIIB与有利的结果呈正相关,独立于初始损害的严重程度,年龄,病变体积(P<0.01)。小脑总体积没有表现出显著的结构-结果关联。本研究表明,参与运动和认知功能的不同小脑小叶的卒中前解剖可能与急性非小脑卒中后的结果有关。从而促进了中风后恢复过程的结构性大脑储备的新兴概念。