RESUMO
This study aimed to evaluate the clinical significance of diffusion tensor imaging (DTI) in the early diagnosis of pyramidal tract Wallerian degeneration (WD) and assessment of neurological recovery following cerebral infarction. This study included 23 patients with acute cerebral infarction and 10 healthy adult controls. All participants underwent both magnetic resonance imaging (MRI) and DTI scans. DTI images were analyzed using the Functional MRI of the Brain Software Library to determine the regions of interest (ROI) and obtain the mean diffusivity (MD) and fractional anisotropy (FA) value for each ROI. The correlation between FA or MD and postinfarction functional recovery of the nervous system was further analyzed to assess the feasibility of using a DTI scan in the evaluation of functional recovery of the nervous system in patients with cerebral infarction. DTI may be useful in detecting signals of early postinfarction pyramidal tract WD and is useful for the evaluation of postinfarction neurological recovery. Cerebral lesions were detected using MRI in all patients. It was found that in some patients, the FA value of the ipsilateral pyramidal tract on DTI was decreased as early as day 3 after the onset of infarction and in all patients by day 7. Subsequent correlation studies showed that the FA value of the ipsilateral pyramidal tract on day 13 was negatively correlated with the National Institutes of Health Stroke Scale score, but positively correlated with the Barthel Index, motricity index, and modified Rankin Scale scores.
Assuntos
Infarto Cerebral/complicações , Imagem de Tensor de Difusão , Degeneração Walleriana/diagnóstico , Degeneração Walleriana/etiologia , Degeneração Walleriana/reabilitação , Estudos de Casos e Controles , HumanosRESUMO
Las lesiones del nervio periférico constituyen una condición clínica frecuente; por ello, entender su fisiopatología y los avances en el campo de la regeneración nerviosa es fundamental para brindar el mejor tratamiento a los pacientes. En los últimos años se ha venido dando cada vez mayor importancia a los eventos regenerativos después de la lesión, donde interviene en gran medida una expresión fenotípica única en este proceso, derivada de células ya presentes, fenómeno clave para la recuperación de la función del nervio lesionado. Este artículo revisó la literatura disponible con el objetivo de entender mejor este evento regenerativo y se encontraron procesos celulares y moleculares que suceden en los axones.
Peripheral nerve injuries are a common clinical condición for which the understanding of the pathophysiology and advances in the fteld of nerve regeneration are important to provide the best treatment for patients. In recent years, it has been giving increasing importance to the regenerative events after injury, where it operares largely unique phenotypic expression in this process, derived from cells already present, kev event for the recoven- of nerve function injured. A review of the literature is done with the aim of a better understanding of this regenerative event, fínding a series of cellular and molecular processes that go on axonal level.