편마비 뇌성 마비 환자에서 재활치료 이후 손상된 뇌피질 척수로의 회복

Title
편마비 뇌성 마비 환자에서 재활치료 이후 손상된 뇌피질 척수로의 회복
Other Titles
Does Injured Corticospinal Tract Recover after Rehabilitation Therapy in Patients with Hemiplegic Cerebral Palsy?
Author(s)
손수민장성호안상호조윤우문한구곽소영김한선조희경
Keywords
Diffusion tensor imaging; Corticospinal tract; Hemiplegia
Issue Date
201002
Publisher
대한재활의학회
Citation
Annals of Rehabilitation Medicine, v.34, no.1, pp.79 - 84
Abstract
Objective: To investigate whether injured corticospinal tract (CST) could recover after rehabilitative therapy in hemiplegic patients with cerebral palsy using diffusion tensor tractography (DTT) which is known to be useful in detecting microscopic white matter lesion in vivo. Method: Sixteen hemiplegic patients (mean age, 13.6 months) were enrolled. Diffuse tensor image (DTI) and gross motor functional measurement (GMFM) evaluation were performed before rehabilitative therapy and at follow-up. We measured the fractional anisotropy (FA), and apparent diffusion coefficient (ADC) of CST in the affected and unaffected hemisphere. To evaluate asymmetry of affected and unaffected CST, asymmetry index of fractional anisotropy (AA) and asymmetry index of apparent diffusion coefficient (AD) were measured. Results: The FA value of the affected CST was lower than that of the unaffected CST and the ADC value was higher than that of the unaffected CST in initial and follow up DTT (p<0.001). Compared with the result of initial DTT, the results of follow up DTT demonstrated that the FA value of both CST was increased (p=0.000). A significant increase in AA was showed in all patients (p=0.000) and the increase of AA had significant correlation with the increase of FA of affected CST, but not with the unaffected CST (r=0.537, p=0.032). Conclusion: DTT would be a powerful modality not only for diagnosis and prognosis of cerebral palsy, but also assessment of microstructural change of CST after rehabilitative therapy. (J Korean Acad Rehab Med 2010; 34: 79-84)
URI
http://hdl.handle.net/YU.REPOSITORY/22885
ISSN
2234-0645
Appears in Collections:
의과대학 > 재활의학교실 > Articles
의과대학 > 소아청소년과학교실 > Articles
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