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Stroke :神经影像学有助于识别从恢复性卒中治疗中获益患者

2018-01-15 国际循环编辑部 国际循环

患者异质性降低了恢复性治疗临床试验的统计效力,既往很多研究关注皮质脊髓束(CST)损伤问题,Stroke发表的一项最新研究评估4大指标对运动训练疗法的行为获益反应的预测能力。

患者异质性降低了恢复性治疗临床试验的统计效力,既往很多研究关注皮质脊髓束(CST)损伤问题,Stroke发表的一项最新研究评估4大指标对运动训练疗法的行为获益反应的预测能力。

研究共计入选47例亚急性慢性偏瘫性卒中患者,行标准上臂运动治疗,评估与基线相比治疗1个月后上臂Fugl-Meyer评分变化情况,根据基线磁共振成像评估CST与卒中的重叠百分比、CST相关萎缩(大脑脚面积)、大脑脚CST完整性(各向异性分数,FA)和内囊后肢的CST完整性等四大损伤指标。

结果发现,CST与卒中的重叠百分比、CST相关萎缩和CST完整性并无相关性,这提示这三项指标可独立反映CST损伤特征。进一步分析发现,CST损伤百分比可显著预测治疗相关行为获益(r=-0.41,P=0.004);其他CST损伤指标、总梗死容积、基线行为缺陷则均对治疗相关行为获益无预测价值。此外,研究发现,关于CST损伤百分比,与重度损伤者相比,轻度损伤者获得治疗相关获益的可能性更大(OR=15.0,95%CI:1.54~147;P<0.005)。

该研究提示,CST损伤百分比可用于预测亚急性-慢性卒中后患者治疗后的运动获益,有望被用作恢复性卒中临床试验中的入选或分层变量以增加统计学效力、减少样本量和降低试验成本。

原始出处:

Jessica M. Cassidy, George Tran, Erin B. Quinlan, et al. Neuroimaging Identifies Patients Most Likely to Respond to a Restorative Stroke Therapy. Stroke. Jan 2018.

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  1. [GetPortalCommentsPageByObjectIdResponse(id=2019748, encodeId=b9332019e4887, content=<a href='/topic/show?id=5ecde428074' target=_blank style='color:#2F92EE;'>#神经影像#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=81, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=74280, encryptionId=5ecde428074, topicName=神经影像)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=7ab72500038, createdName=124985dbm06(暂无昵称), createdTime=Mon Aug 13 09:06:00 CST 2018, time=2018-08-13, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=279807, encodeId=1a672e980751, content=好资料学习了!, beContent=null, objectType=article, channel=null, level=null, likeNumber=101, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=92191944782, createdName=thlabcde, createdTime=Thu Jan 18 21:18:55 CST 2018, time=2018-01-18, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=279057, encodeId=1a922e905735, content=非常好的文章.学习了, beContent=null, objectType=article, channel=null, level=null, likeNumber=92, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/NUyjXTCJjo7LIiaRZTzJ3SEfiauCzTMPW7YvPPYLNJBXG9oh6Al1icq2VQQkIHWxqXehcicTS62YKJVBhxeth3wggw/0, createdBy=7ce01621306, createdName=天涯183, createdTime=Tue Jan 16 11:44:51 CST 2018, time=2018-01-16, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=278869, encodeId=5f052e886968, content=学习一下谢谢, beContent=null, objectType=article, channel=null, level=null, likeNumber=93, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/mONcle9pic3zSn0GqHrsfLGSUSR8zwnWWLT4FMl5XH8S58HuZslVkLsAPbXDXaliagK7TOxQfmngKibG1yrDonepCLDkcxGk8hS/0, createdBy=b8282062892, createdName=changjiu, createdTime=Mon Jan 15 23:35:55 CST 2018, time=2018-01-15, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=278827, encodeId=26e32e88276f, content=好资料学习了!!, beContent=null, objectType=article, channel=null, level=null, likeNumber=105, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=92191944782, createdName=thlabcde, createdTime=Mon Jan 15 21:35:52 CST 2018, time=2018-01-15, status=1, ipAttribution=)]
  2. [GetPortalCommentsPageByObjectIdResponse(id=2019748, encodeId=b9332019e4887, content=<a href='/topic/show?id=5ecde428074' target=_blank style='color:#2F92EE;'>#神经影像#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=81, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=74280, encryptionId=5ecde428074, topicName=神经影像)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=7ab72500038, createdName=124985dbm06(暂无昵称), createdTime=Mon Aug 13 09:06:00 CST 2018, time=2018-08-13, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=279807, encodeId=1a672e980751, content=好资料学习了!, beContent=null, objectType=article, channel=null, level=null, likeNumber=101, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=92191944782, createdName=thlabcde, createdTime=Thu Jan 18 21:18:55 CST 2018, time=2018-01-18, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=279057, encodeId=1a922e905735, content=非常好的文章.学习了, beContent=null, objectType=article, channel=null, level=null, likeNumber=92, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/NUyjXTCJjo7LIiaRZTzJ3SEfiauCzTMPW7YvPPYLNJBXG9oh6Al1icq2VQQkIHWxqXehcicTS62YKJVBhxeth3wggw/0, createdBy=7ce01621306, createdName=天涯183, createdTime=Tue Jan 16 11:44:51 CST 2018, time=2018-01-16, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=278869, encodeId=5f052e886968, content=学习一下谢谢, beContent=null, objectType=article, channel=null, level=null, likeNumber=93, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/mONcle9pic3zSn0GqHrsfLGSUSR8zwnWWLT4FMl5XH8S58HuZslVkLsAPbXDXaliagK7TOxQfmngKibG1yrDonepCLDkcxGk8hS/0, createdBy=b8282062892, createdName=changjiu, createdTime=Mon Jan 15 23:35:55 CST 2018, time=2018-01-15, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=278827, encodeId=26e32e88276f, content=好资料学习了!!, beContent=null, objectType=article, channel=null, level=null, likeNumber=105, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=92191944782, createdName=thlabcde, createdTime=Mon Jan 15 21:35:52 CST 2018, time=2018-01-15, status=1, ipAttribution=)]
    2018-01-18 thlabcde

    好资料学习了!

    0

  3. [GetPortalCommentsPageByObjectIdResponse(id=2019748, encodeId=b9332019e4887, content=<a href='/topic/show?id=5ecde428074' target=_blank style='color:#2F92EE;'>#神经影像#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=81, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=74280, encryptionId=5ecde428074, topicName=神经影像)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=7ab72500038, createdName=124985dbm06(暂无昵称), createdTime=Mon Aug 13 09:06:00 CST 2018, time=2018-08-13, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=279807, encodeId=1a672e980751, content=好资料学习了!, beContent=null, objectType=article, channel=null, level=null, likeNumber=101, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=92191944782, createdName=thlabcde, createdTime=Thu Jan 18 21:18:55 CST 2018, time=2018-01-18, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=279057, encodeId=1a922e905735, content=非常好的文章.学习了, beContent=null, objectType=article, channel=null, level=null, likeNumber=92, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/NUyjXTCJjo7LIiaRZTzJ3SEfiauCzTMPW7YvPPYLNJBXG9oh6Al1icq2VQQkIHWxqXehcicTS62YKJVBhxeth3wggw/0, createdBy=7ce01621306, createdName=天涯183, createdTime=Tue Jan 16 11:44:51 CST 2018, time=2018-01-16, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=278869, encodeId=5f052e886968, content=学习一下谢谢, beContent=null, objectType=article, channel=null, level=null, likeNumber=93, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/mONcle9pic3zSn0GqHrsfLGSUSR8zwnWWLT4FMl5XH8S58HuZslVkLsAPbXDXaliagK7TOxQfmngKibG1yrDonepCLDkcxGk8hS/0, createdBy=b8282062892, createdName=changjiu, createdTime=Mon Jan 15 23:35:55 CST 2018, time=2018-01-15, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=278827, encodeId=26e32e88276f, content=好资料学习了!!, beContent=null, objectType=article, channel=null, level=null, likeNumber=105, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=92191944782, createdName=thlabcde, createdTime=Mon Jan 15 21:35:52 CST 2018, time=2018-01-15, status=1, ipAttribution=)]
    2018-01-16 天涯183

    非常好的文章.学习了

    0

  4. [GetPortalCommentsPageByObjectIdResponse(id=2019748, encodeId=b9332019e4887, content=<a href='/topic/show?id=5ecde428074' target=_blank style='color:#2F92EE;'>#神经影像#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=81, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=74280, encryptionId=5ecde428074, topicName=神经影像)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=7ab72500038, createdName=124985dbm06(暂无昵称), createdTime=Mon Aug 13 09:06:00 CST 2018, time=2018-08-13, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=279807, encodeId=1a672e980751, content=好资料学习了!, beContent=null, objectType=article, channel=null, level=null, likeNumber=101, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=92191944782, createdName=thlabcde, createdTime=Thu Jan 18 21:18:55 CST 2018, time=2018-01-18, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=279057, encodeId=1a922e905735, content=非常好的文章.学习了, beContent=null, objectType=article, channel=null, level=null, likeNumber=92, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/NUyjXTCJjo7LIiaRZTzJ3SEfiauCzTMPW7YvPPYLNJBXG9oh6Al1icq2VQQkIHWxqXehcicTS62YKJVBhxeth3wggw/0, createdBy=7ce01621306, createdName=天涯183, createdTime=Tue Jan 16 11:44:51 CST 2018, time=2018-01-16, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=278869, encodeId=5f052e886968, content=学习一下谢谢, beContent=null, objectType=article, channel=null, level=null, likeNumber=93, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/mONcle9pic3zSn0GqHrsfLGSUSR8zwnWWLT4FMl5XH8S58HuZslVkLsAPbXDXaliagK7TOxQfmngKibG1yrDonepCLDkcxGk8hS/0, createdBy=b8282062892, createdName=changjiu, createdTime=Mon Jan 15 23:35:55 CST 2018, time=2018-01-15, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=278827, encodeId=26e32e88276f, content=好资料学习了!!, beContent=null, objectType=article, channel=null, level=null, likeNumber=105, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=92191944782, createdName=thlabcde, createdTime=Mon Jan 15 21:35:52 CST 2018, time=2018-01-15, status=1, ipAttribution=)]
    2018-01-15 changjiu

    学习一下谢谢

    0

  5. [GetPortalCommentsPageByObjectIdResponse(id=2019748, encodeId=b9332019e4887, content=<a href='/topic/show?id=5ecde428074' target=_blank style='color:#2F92EE;'>#神经影像#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=81, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=74280, encryptionId=5ecde428074, topicName=神经影像)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=7ab72500038, createdName=124985dbm06(暂无昵称), createdTime=Mon Aug 13 09:06:00 CST 2018, time=2018-08-13, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=279807, encodeId=1a672e980751, content=好资料学习了!, beContent=null, objectType=article, channel=null, level=null, likeNumber=101, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=92191944782, createdName=thlabcde, createdTime=Thu Jan 18 21:18:55 CST 2018, time=2018-01-18, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=279057, encodeId=1a922e905735, content=非常好的文章.学习了, beContent=null, objectType=article, channel=null, level=null, likeNumber=92, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/NUyjXTCJjo7LIiaRZTzJ3SEfiauCzTMPW7YvPPYLNJBXG9oh6Al1icq2VQQkIHWxqXehcicTS62YKJVBhxeth3wggw/0, createdBy=7ce01621306, createdName=天涯183, createdTime=Tue Jan 16 11:44:51 CST 2018, time=2018-01-16, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=278869, encodeId=5f052e886968, content=学习一下谢谢, beContent=null, objectType=article, channel=null, level=null, likeNumber=93, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/mONcle9pic3zSn0GqHrsfLGSUSR8zwnWWLT4FMl5XH8S58HuZslVkLsAPbXDXaliagK7TOxQfmngKibG1yrDonepCLDkcxGk8hS/0, createdBy=b8282062892, createdName=changjiu, createdTime=Mon Jan 15 23:35:55 CST 2018, time=2018-01-15, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=278827, encodeId=26e32e88276f, content=好资料学习了!!, beContent=null, objectType=article, channel=null, level=null, likeNumber=105, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=92191944782, createdName=thlabcde, createdTime=Mon Jan 15 21:35:52 CST 2018, time=2018-01-15, status=1, ipAttribution=)]
    2018-01-15 thlabcde

    好资料学习了!!

    0

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