@article{oai:nagasaki-u.repo.nii.ac.jp:00001137,
 author = {Nakashima, Akira and Ishizaka, Shunsuke and Hamaue, Yohei and Kuriyama, Ami and Kataoka, Hideki and Nakashima, Ryusei and Koizumi, Tetuji and Shimizu, Tadashi and Ryu, Nobutoshi and Higashi, Toshio},
 journal = {保健学研究, Health Science Research},
 month = {Jul},
 note = {Purpose: Diffusion tensor imaging (DTI) has garnered attention regarding the prediction of patient outcomes following stroke and its application in clinical practice is expected. Here, we evaluated the usefulness of combination analysis with fractional anisotropy (FA) and tractography parameters in order to build an optimal DTI protocol to predict motor recovery after stroke. 
Subjects and Methods: We recruited 35 consecutive patients with supratentorial hemorrhagic or 
ischemic stroke. DTI examination took place 14－16 days after stroke onset and the bilateral cerebral 
peduncles were regions of interest for the FA and tractography analyses. Three months after stroke, 
Brunnstrom recovery stage (BRS) scoring of the upper limb and fingers was performed. We tested 
correlations between the FA ratio (rFA) of the bilateral cerebral peduncles, tractography findings, and BRS scores. Results: A significant correlation was identified between rFA and 3-month BRS score (r ＝ 0.465, p = 0.008). The pattern of tractography was divided into 2 groups (complete-disrupted type and incomplete-disrupted type). The patients with the incomplete-disrupted type had significantly higher rFA (p = 0.008) and BRS scores (p < 0.001). After excluding patients with the complete-disrupted type who had high rFA, we observed statistically significant strong positive correlations between rFA and the BRS scores (r = 0.728, p < 0.001). Conclusions: Combination analysis with FA and tractography may be a useful predictor of motor recovery in the acute phase of stroke., 目的：脳卒中後の運動麻痺の予後を予測する方法として拡散テンソル画像（DTI）が注目されており，その臨床応用が期待されている．そこで本研究では，脳卒中後の運動麻痺の予後予測における最適なDTIプロトコールを構築するために拡散異方性（FA）と tractography の組み合わせによる解析の有用性を検証した．方法：本研究では脳出血，脳梗塞を呈した35名を対象とした．DTI は脳卒中発症14 ～ 16病日目に撮像し，大脳脚を関心領域としFA及び tractography を抽出した．また身体機能は脳卒中発症 3 か月後に上肢と手指の Brunnstrom stage （BRS）を用いて評価した．解析は，tractography による皮質脊髄路の評価とrFA（両側大脳脚の FA 比）を組み合わせ，BRSとの相関関係を調査した．結果：rFAと 3 ヶ月後の BRS スコアとの間には，有意な正の相関を認めた（r = 0.465, p = 0.008）．Tractographyは 2 群（complete-disrupted type and incomplete-disrupted type） に分けられ，completedisrupted type に比べ incomplete-disrupted type は，rFA（p = 0.008）および BRS スコア（p < 0.001）が有意に高かった．高い rFA を有する complete-disrupted type の患者を除外した後の rFA と BRS スコアとの間には，より強い正の相関を認めた（r = 0.728, p < 0.001）．結論：FAと tractography を組み合わせて解析することは，急性期脳卒中患者における運動麻痺の有用な予測因子である可能性が示唆された．, 保健学研究, 31, pp.1-8; 2018},
 pages = {1--8},
 title = {Fractional Anisotropy and Tractography in Diffusion Tensor Imaging for the Prediction of Upper Limb Motor Recovery After Stroke},
 volume = {31},
 year = {2018}
}