The corticoreticular tract （CRT） is known to be involved in walking and postural control. Using diffusion tensor tractography （DTT）, we investigated the relationship between the CRT and gait dysfunction, includ- i...The corticoreticular tract （CRT） is known to be involved in walking and postural control. Using diffusion tensor tractography （DTT）, we investigated the relationship between the CRT and gait dysfunction, includ- ing trunk instability, in pediatric patients. Thirty patients with delayed development and 15 age-matched, typically-developed （TD） children were recruited. Fifteen patients with gait dysfunction （bilateral trunk instability） were included in the group A, and the other 15 patients with gait dysfunction （unilateral trunk instability） were included in the group B. The Growth Motor Function Classification System, Functional Ambulation Category scale, and Functional Ambulation Category scale were used for measurement of functional state. Fractional anisotropy, apparent diffusion coefficient, fiber number, and tract integrity of the CRT and corticospinal tract were measured. Diffusion parameters or integrity of corticospinal tract were not significantly different in the three study groups. However, CRT results revealed that both CRTs were disrupted in the group A, whereas CRT disruption in the hemispheres contralateral to clinical mani- festations was observed in the group B. Fractional anisotropy values and fiber numbers in both CRTs were decreased in the group A than in the group TD. The extents of decreases of fractional anisotropy values and fiber numbers on the ipsilateral side relative to those on the contralateral side were greater in the group B than in the group TD. Functional evaluation data and clinical manifestations were found to show strong correlations with CRT status, rather than with corticospinal tract status. These findings suggest that CRT status appears to be clinically important for gait function and trunk stability in pediatric patients and DTT can help assess CRT status in pediatric patients with gait dysfunction.展开更多
Duchenne muscular dystrophy (DMD) is a genetic disorder linked to chromosome Xp21, due to absence of dystrophin production. It is clinically characterized by progressive muscle weakness, fatigue, and development of jo...Duchenne muscular dystrophy (DMD) is a genetic disorder linked to chromosome Xp21, due to absence of dystrophin production. It is clinically characterized by progressive muscle weakness, fatigue, and development of joint contractures that compromise general motor functionality, mainly the gait. Objective: To characterize the motor function and decrease gait in children with DMD using the Portuguese version of the Motor Function Measure scale (MFM-P). Methods: A review of medical records including chronological age and scores from MFM-P of children with a DMD who attended at the Neuromuscular Diseases Clinic at Campinas State University (UNICAMP), Brazil was performed in this study. A total of 36 medical records of male patients with confirmed clinical diagnosis of DMD, ambulatory or not, regardless of age;excluding those with other associated diseases or other types of muscular dystrophies were selected. Data were analyzed using Kolmogorov-Smirnov and Spearman correlation statistical tests. Results: Analysis of all data collected showed that 75% of our sample had D1 scores lower than 41.02%. There was a linear relationship between the scores of D2 and D3, but no association between D2 and D1 scores was noted. D1 score was between 40% and 80% in those patients presenting D2 scores between 80% and 100%. In all cases patients with low total score presented a greater risk for loss of gait and their functionality. Conclusion: The standing posture and the postural transfers were the worst activities observed in children with DMD, with positive correlation between proximal and distal motor function. Even with high scores according MFM-P in proximal function, the children showed strong predictors for loss of gait.展开更多
目的分析美国国立卫生研究院卒中量表(National Institutes of Health stroke scale,NIHSS)评分、老年营养风险指数(geriatric nutritional risk index,GNRI)、运动功能独立性评定(motor function independence measure,MFIM)评分与卒...目的分析美国国立卫生研究院卒中量表(National Institutes of Health stroke scale,NIHSS)评分、老年营养风险指数(geriatric nutritional risk index,GNRI)、运动功能独立性评定(motor function independence measure,MFIM)评分与卒中相关性肺炎(stroke-related pneumonia,SAP)风险的关系。方法纳入2021年11月至2022年5月卒中入院的患者,收集入院时NIHSS、GNRI、MFIM评分,根据卒中发病后1周内是否发生肺炎分为SAP组和非SAP组。使用受试者工作特征(receiver operating characteristic,ROC)曲线分析各评分最佳截断点并将评分转换为分类变量,采用多因素logistic回归模型和限制性立方样条分析各评分与SAP之间的关系。结果研究共纳入318例卒中患者,SAP组86例,非SAP组232例。logistic回归结果显示,NIHSS评分(OR=32.783,95%CI:16.366~65.671,P<0.001)、MFIM评分(OR=0.052,95%CI:0.027~0.100,P<0.001)和GNRI评分(OR=0.262,95%CI:0.144~0.476,P<0.001)与SAP存在关联。限制性立方样条分析显示,NIHSS评分(P_(总趋势)<0.001,P_(非线性)=0.002)、GNRI评分(P_(总趋势)<0.001,P_(非线性)<0.001)与SAP风险之间存在非线性剂量-反应关系。结论NIHSS、MFIM、GNRI评分和卒中患者SAP发生风险相关,其中NIHSS和GNRI评分与其存在非线性关联。展开更多
基金supported by Basic Science Research Program through the National Research Foundation of Korea(NRF)funded by the Ministry of Education,Science and Technology(2012-013997)
文摘The corticoreticular tract （CRT） is known to be involved in walking and postural control. Using diffusion tensor tractography （DTT）, we investigated the relationship between the CRT and gait dysfunction, includ- ing trunk instability, in pediatric patients. Thirty patients with delayed development and 15 age-matched, typically-developed （TD） children were recruited. Fifteen patients with gait dysfunction （bilateral trunk instability） were included in the group A, and the other 15 patients with gait dysfunction （unilateral trunk instability） were included in the group B. The Growth Motor Function Classification System, Functional Ambulation Category scale, and Functional Ambulation Category scale were used for measurement of functional state. Fractional anisotropy, apparent diffusion coefficient, fiber number, and tract integrity of the CRT and corticospinal tract were measured. Diffusion parameters or integrity of corticospinal tract were not significantly different in the three study groups. However, CRT results revealed that both CRTs were disrupted in the group A, whereas CRT disruption in the hemispheres contralateral to clinical mani- festations was observed in the group B. Fractional anisotropy values and fiber numbers in both CRTs were decreased in the group A than in the group TD. The extents of decreases of fractional anisotropy values and fiber numbers on the ipsilateral side relative to those on the contralateral side were greater in the group B than in the group TD. Functional evaluation data and clinical manifestations were found to show strong correlations with CRT status, rather than with corticospinal tract status. These findings suggest that CRT status appears to be clinically important for gait function and trunk stability in pediatric patients and DTT can help assess CRT status in pediatric patients with gait dysfunction.
文摘Duchenne muscular dystrophy (DMD) is a genetic disorder linked to chromosome Xp21, due to absence of dystrophin production. It is clinically characterized by progressive muscle weakness, fatigue, and development of joint contractures that compromise general motor functionality, mainly the gait. Objective: To characterize the motor function and decrease gait in children with DMD using the Portuguese version of the Motor Function Measure scale (MFM-P). Methods: A review of medical records including chronological age and scores from MFM-P of children with a DMD who attended at the Neuromuscular Diseases Clinic at Campinas State University (UNICAMP), Brazil was performed in this study. A total of 36 medical records of male patients with confirmed clinical diagnosis of DMD, ambulatory or not, regardless of age;excluding those with other associated diseases or other types of muscular dystrophies were selected. Data were analyzed using Kolmogorov-Smirnov and Spearman correlation statistical tests. Results: Analysis of all data collected showed that 75% of our sample had D1 scores lower than 41.02%. There was a linear relationship between the scores of D2 and D3, but no association between D2 and D1 scores was noted. D1 score was between 40% and 80% in those patients presenting D2 scores between 80% and 100%. In all cases patients with low total score presented a greater risk for loss of gait and their functionality. Conclusion: The standing posture and the postural transfers were the worst activities observed in children with DMD, with positive correlation between proximal and distal motor function. Even with high scores according MFM-P in proximal function, the children showed strong predictors for loss of gait.
文摘目的分析美国国立卫生研究院卒中量表(National Institutes of Health stroke scale,NIHSS)评分、老年营养风险指数(geriatric nutritional risk index,GNRI)、运动功能独立性评定(motor function independence measure,MFIM)评分与卒中相关性肺炎(stroke-related pneumonia,SAP)风险的关系。方法纳入2021年11月至2022年5月卒中入院的患者,收集入院时NIHSS、GNRI、MFIM评分,根据卒中发病后1周内是否发生肺炎分为SAP组和非SAP组。使用受试者工作特征(receiver operating characteristic,ROC)曲线分析各评分最佳截断点并将评分转换为分类变量,采用多因素logistic回归模型和限制性立方样条分析各评分与SAP之间的关系。结果研究共纳入318例卒中患者,SAP组86例,非SAP组232例。logistic回归结果显示,NIHSS评分(OR=32.783,95%CI:16.366~65.671,P<0.001)、MFIM评分(OR=0.052,95%CI:0.027~0.100,P<0.001)和GNRI评分(OR=0.262,95%CI:0.144~0.476,P<0.001)与SAP存在关联。限制性立方样条分析显示,NIHSS评分(P_(总趋势)<0.001,P_(非线性)=0.002)、GNRI评分(P_(总趋势)<0.001,P_(非线性)<0.001)与SAP风险之间存在非线性剂量-反应关系。结论NIHSS、MFIM、GNRI评分和卒中患者SAP发生风险相关,其中NIHSS和GNRI评分与其存在非线性关联。
