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目的:利用磁共振弥散张量成像(DTI)探究卒中后淡漠发病的结构基础。方法:将54例缺血性脑卒中恢复期患者根据淡漠的临床诊断分为淡漠组(n=31)与非淡漠组(n=23),并采集颅脑T1、T2以及DT1序列MR影像;比较两组间年龄、性别、教育程度、神经功能缺损(NIHSS)评分及梗塞灶位置,然后利用DTl进行基于体素的分析(VBA)以探究卒中后淡漠结构基础。结果:AES-C评分存在两组间存在统计学差异(P-0.00),余各项资料则未发现组间差异。左侧前部放射冠区、胼胝体膝部、压部、毯部的FA值在淡漠组明显下降(P<0.05)。结论:左侧额叶-皮质下环路及胼胝体膝部、压部、毯部白质结构的破坏可能与卒中后淡漠有关。
OBJECTIVE: To explore the structural basis of apathetic onset after stroke using magnetic resonance diffusion tensor imaging (DTI). Methods: Fifty-four patients with convalescent ischemic stroke were divided into indifferent group (n = 31) and non-indifferent group (n = 23) according to indifferent clinical diagnosis. Brain T1, T2 and DT1 MR images were collected. The age, gender, educational attainment, NIHSS score, and infarct location were compared between the two groups. Voxel-based analysis (VBA) was then performed using DTl to explore the apathetic postural structural basis. Results: There was a significant difference between the two groups in the AES-C score (P-0.00), but no differences between groups were found in any of the other data. FA values of left anterior corona, corpus callosum knee, pressure and blanket decreased significantly in indifferent group (P <0.05). CONCLUSION: The destruction of white matter structure in the left frontal lobe-subcortical loop and the corpus callosum may be related to indifference after stroke.