BACKGROUND Patients with Parkinson's disease(PD)exhibit symptoms such as antecollis(AC)and camptocormia(CC).The pathology of these two conditions is unclear.Additionally,standard treatment methods have not been es...BACKGROUND Patients with Parkinson's disease(PD)exhibit symptoms such as antecollis(AC)and camptocormia(CC).The pathology of these two conditions is unclear.Additionally,standard treatment methods have not been established.The article reports the case of a 65-year-old female patient with AC and CC who was treated with central and peripheral interventions to alleviate symptoms.CASE SUMMARY We present the case of a 65-year-old female PD patient with AC and CC.The course of the disease was 5 years.She was treated with rehabilitation strategies such as sensory tricks and trunk strength training.During the inpatient period,we compared and analyzed the patient's gait,rehabilitation assessment scale score,and angles of her abnormal trunk posture in the first week,the third week,and the fifth week.The patient's stride length increased,indicating that the patient's walking ability was improved.The Unified Parkinson's Disease Scale Part Three score and CC severity score decreased.Furthermore,the score of the other scale increased.In addition,the patient showed significant improvements in AC,upper CC,and lower CC angles.CONCLUSION This case study suggested that sensory tricks and trunk strength training are beneficial and safe for patients with AC and CC.展开更多
Median arcuate ligament syndrome (MALS), is a rare abdominal vascular compression syndrome caused by the compression of the proximal celiac trunk by the median arcuate ligament. According to many authors, a low insert...Median arcuate ligament syndrome (MALS), is a rare abdominal vascular compression syndrome caused by the compression of the proximal celiac trunk by the median arcuate ligament. According to many authors, a low insertion of the diaphragmatic crura or an abnormally high origin of the celiac trunk from the aorta can cause compression of the celiac artery. Usually, patients with MALS are asymptomatic. Computed tomography (CT) angiography of the abdomen is the main imaging modality to confirm the diagnosis. The coexistence of celiac trunk and superior mesenteric artery compression by the median arcuate ligament is rarely described in the literature. To our knowledge, until now, a simultaneous combination of three abdominal vascular compressions by the median arcuate ligament has never been described. From this case, we report a simultaneous compression of the celiac trunk, superior mesenteric artery, and renal arteries by the median arcuate ligament.展开更多
The blood supply to the most of abdominal organs is provided by the branches of CT. The SMA supply caecum, ascends colon, all of the small bowels except the upper part of duodenum. Knowledge of variable anatomy of cel...The blood supply to the most of abdominal organs is provided by the branches of CT. The SMA supply caecum, ascends colon, all of the small bowels except the upper part of duodenum. Knowledge of variable anatomy of celiac axis and SMA may be useful in planning and executing radiological interventions such as celiacography and chemoembolization of hepatic and pancreatic tumors. In this study, the uncommon or low percentage cases of CT and SMA are presented in the light of clinical and embryological information. The celiac axises of a total of 30 adult corpses were examined. Dissections of abdominal region were performed in detail according to Cunningham’s manual. Angiographic images of 100 consecutive adult patients who underwent celiac MDCT angiography were evaluated. During autopsies, an incomplete celiac trunk or bifurcation of celiac trunk associated with the hepatomesenteric and gastrosplenic trunks (0.7%) and a celiacomesenteric trunk associated with high origin superior mesenteric artery and gastrosplenic trunk were detected (0.7%). During MDCT angiography, a case of total absence of celiac trunk associated with a hepatosplenomesenteric trunk (0.7%) and also a case of total absence of celiac trunk alone were observed (0.7%). The persistence or unusual development of ventral splanchnic arteries (VSAs) or ventral longitudinal anastomosis may result in variations or the unusual trunks related to celiac axis and SMA. The anomalous trunks of the CT may be result of either the persistence of some parts of the VSAs or ventral longitudinal anastomose that normally disappear or disappearance of parts that normally persist. The prevalence of unusual trunks of celiac axis and SMA in this study is quite low in literature. These abnormal vessels pose problems for surgeons and radiologists. Such vascular anomalies may cause clinical complications following surgical and radiological procedures such as resection of tumor of the pancreatic head, lymphadenectomy, coeliacography, aortic replacement with reimplantation of the trunk and coembolization of pancreatic and liver tumors.展开更多
Single-tree detection is one of the main research topics in quantifying the structural properties of forests. Drone Li DAR systems and terrestrial laser scanning systems produce high-density point clouds that offer gr...Single-tree detection is one of the main research topics in quantifying the structural properties of forests. Drone Li DAR systems and terrestrial laser scanning systems produce high-density point clouds that offer great promise for forest inventories in limited areas. However, most studies have focused on the upper canopy layer and neglected the lower forest structure. This paper describes an innovative tree detection method using drone Li DAR data from a new perspective of the under-canopy structure. This method relies on trunk point clouds, with undercanopy sections split into heights ranging from 1 to 7 m, which were processed and compared, to determine a suitable height threshold to detect trees. The method was tested in a dense cedar plantation forest in the Aichi Prefecture, Japan, which has a stem density of 1140 stems·ha^(-1) and an average tree age of 42 years. Dense point cloud data were generated from the drone Li DAR system and terrestrial laser scanning with an average point density of 5000 and 6500 points·m^(-2), respectively. Tree detection was achieved by drawing point-cloud section projections of tree trunks at different heights and calculating the center coordinates. The results show that this trunk-section-based method significantly reduces the difficulty of tree detection in dense plantation forests with high accuracy(F1-Score=0.9395). This method can be extended to different forest scenarios or conditions by changing section parameters.展开更多
Background: Trunk volume(Vt) is an essential parameter for estimating forest stand volume, biomass, and carbon sequestration potential. As the dominant tree species in desert riparian forests, Euphrates poplar(Populus...Background: Trunk volume(Vt) is an essential parameter for estimating forest stand volume, biomass, and carbon sequestration potential. As the dominant tree species in desert riparian forests, Euphrates poplar(Populus euphratica) has a high proportion of irregularly shaped tree trunks along the Tarim River, NW China, where the habitat is very fragile owing to long-term water stress. This causes uncertainty in estimation accuracy as well as technical challenges for forest surveys. Our study aimed to acquire P. euphratica Vtusing terrestrial laser scanning(TLS) and to establish a species-specific Vtprediction model.Methods: A total of 240 individual trees were measured by TLS multiple-station in 12 sampling plots in three sections along the lower reaches of the Tarim River. Vtwas calculated by a definite integration method using trunk diameters(Di) at every 0.1-m tree height obtained from TLS, and all data were split randomly into two sets:70% of data were used to estimate the model parameter calibration, and the remaining 30% were used for model validation. Sixteen widely used candidate tree Vtestimation models were fitted to the TLS-measured Vtand tree structural parameter data, including tree height(H), diameter at breast height(DBH), and basal diameter(BD). All model performances were evaluated and compared by the statistical parameters of determination coefficient(R^(2)),root mean square error(RMSE), Bayesian information criterion(BIC), mean prediction error(ME), mean absolute error(MAE), and modeling efficiency(EF), and accordingly the best model was selected.Results: TLS point cloud reflection intensity(RI) has advantageous in the extraction of data from irregular tree trunk structures. The P. euphratica tree Vtvalues showed obvious differences at the same tree height(H). There was no significant correlation between Vtand H(R^(2)=0.11, P < 0.01), which reflected the irregularity of P. euphratica trunk shape in the study area. Among all the models, model(14): Vt=0.909DBH1.184H0.487BD0.836(R^(2)=0.97, RMSE=0.14) had the best prediction capability for irregularly shaped Vtwith the highest R^(2), BIC(-37.96), and EF(0.96), and produced a smaller ME(0.006) and MAE(1.177) compared to other models. The prediction accuracy was 93.18%.Conclusions: TLS point cloud RI has a potential for nondestructively measuring irregularly shaped trunk structures of P. euphratica and developed Vtprediction models. The multivariate models more effectively predicted Vtfor irregularly shaped trees compared to one-way and general volume models.展开更多
In this study,the potential of a low-cost bio-adsorbent,taken directly from Date Palm Trunk Fibers(DPTF)agricultural wastes,for cadmium ions removal from wastewaters is examined.The performances of this adsorbent are ...In this study,the potential of a low-cost bio-adsorbent,taken directly from Date Palm Trunk Fibers(DPTF)agricultural wastes,for cadmium ions removal from wastewaters is examined.The performances of this adsorbent are evaluated by building breakthrough curves at different bed heights and flow rates while keeping other parameters,such as the initial feed concentration,pH,and particle size,constant.The results indicate that the maximum cadmium adsorption capacity of DTPF can be obtained from the Thomas model as 51.5 mg/g with the most extended mass transfer zone of 83 min at the lowest flow rate at 5 ml/min.The saturation concentrations(NO)and the rate constant(kab)obtained from the BDST(bed depth service time)model are 7022.16 mg/l and 0.0536 l/mg.min,respectively.Using the Yon-Nelsen Model,it is found that operating at a lower flow rate leads to a larger value of the elapsed needed time to reach a 50%breakthrough.The Wolborska model indicates that the bed capacity increases with decreasing the flow rate,and the adsorbent can achieve a greater external mass transfer kinetic coefficient(2.271/min)at a higher flow rate.展开更多
Objective: The purpose of this study was to clarify the relationship between respiratory muscle strength and skeletal muscle mass (trunk, upper limbs, and lower limbs) in older people who were certified as requiring n...Objective: The purpose of this study was to clarify the relationship between respiratory muscle strength and skeletal muscle mass (trunk, upper limbs, and lower limbs) in older people who were certified as requiring nursing or supportive care. Methods: Thirty-five older people (65 years or older) who were certified as requiring nursing care or support were included in the study. The subjects were divided into a non-sarcopenic group (n = 12) and a sarcopenic group (n = 23) according to the sarcopenia diagnostic criteria proposed by the Asian Working Group for Sarcopenia. Maximum inspiratory pressure, maximum expiratory pressure, skeletal muscle mass (trunk, upper and lower limbs), and hand grip strength were measured. Pearson’s correlation coefficient and multiple regression analysis were used for statistical processing. Results: In the non-sarcopenic group, both expiratory muscle strength and hand grip strength were correlated with skeletal muscle mass. In the sarcopenia group, expiratory muscle strength was not correlated with skeletal muscle mass, and only hand grip strength was correlated with upper limb muscle mass. Multiple regression analysis revealed that, in the non-sarcopenic group, trunk muscle mass was the primary factor in expiratory muscle strength and upper limb muscle mass was the primary factor in hand grip strength. In the sarcopenia group, upper limb muscle mass was found to be the main factor in hand grip strength. Conclusion: Our results highlight the importance of assessing expiratory muscle strength and trunk muscle mass before sarcopenia develops in older people who require support and nursing care.展开更多
Trunk function has been identified as an important early predictor of functional outcome after stroke and the same deteriorates on both contralateral and ipsilateral sides of the body following stroke. The primary con...Trunk function has been identified as an important early predictor of functional outcome after stroke and the same deteriorates on both contralateral and ipsilateral sides of the body following stroke. The primary contribution of the trunk muscles is to allow the body to remain upright, adjust weight shifts, and control movements against constant pull of gravity and is considered central key point of the body. Proximal stability of the trunk is a pre-requisite for distal limb mobility, balance, gait and functional activities and its positive correlation in hemiplegia has been demonstrated in a cross- sectional study. Both isokinetic and handheld dynamometer muscle strength testing demonstrated the weakness of bilateral trunk flexors, extensors and rotator muscles in both acute and chronic hemiplegic patients. This was confirmed by electromyography analysis which identified poor bilateral trunk muscles activity in patients with stroke. Trunk impairment scale is sensitive to evaluate the selective muscle control of upper and lower trunk, and it has been reported that lateral flexion of the trunk is easier than rotation of the trunk and the clinical observation concurs to the difficulty in lower trunk rotation of stroke patients. However, trunk exercises given early after stroke could produce enhanced balance performance post- stroke. This review attempts to report the evidence supporting the involvement of the trunk and its influence on balance and functional performance in post-stroke hemiplegia.展开更多
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
文摘BACKGROUND Patients with Parkinson's disease(PD)exhibit symptoms such as antecollis(AC)and camptocormia(CC).The pathology of these two conditions is unclear.Additionally,standard treatment methods have not been established.The article reports the case of a 65-year-old female patient with AC and CC who was treated with central and peripheral interventions to alleviate symptoms.CASE SUMMARY We present the case of a 65-year-old female PD patient with AC and CC.The course of the disease was 5 years.She was treated with rehabilitation strategies such as sensory tricks and trunk strength training.During the inpatient period,we compared and analyzed the patient's gait,rehabilitation assessment scale score,and angles of her abnormal trunk posture in the first week,the third week,and the fifth week.The patient's stride length increased,indicating that the patient's walking ability was improved.The Unified Parkinson's Disease Scale Part Three score and CC severity score decreased.Furthermore,the score of the other scale increased.In addition,the patient showed significant improvements in AC,upper CC,and lower CC angles.CONCLUSION This case study suggested that sensory tricks and trunk strength training are beneficial and safe for patients with AC and CC.
文摘Median arcuate ligament syndrome (MALS), is a rare abdominal vascular compression syndrome caused by the compression of the proximal celiac trunk by the median arcuate ligament. According to many authors, a low insertion of the diaphragmatic crura or an abnormally high origin of the celiac trunk from the aorta can cause compression of the celiac artery. Usually, patients with MALS are asymptomatic. Computed tomography (CT) angiography of the abdomen is the main imaging modality to confirm the diagnosis. The coexistence of celiac trunk and superior mesenteric artery compression by the median arcuate ligament is rarely described in the literature. To our knowledge, until now, a simultaneous combination of three abdominal vascular compressions by the median arcuate ligament has never been described. From this case, we report a simultaneous compression of the celiac trunk, superior mesenteric artery, and renal arteries by the median arcuate ligament.
文摘The blood supply to the most of abdominal organs is provided by the branches of CT. The SMA supply caecum, ascends colon, all of the small bowels except the upper part of duodenum. Knowledge of variable anatomy of celiac axis and SMA may be useful in planning and executing radiological interventions such as celiacography and chemoembolization of hepatic and pancreatic tumors. In this study, the uncommon or low percentage cases of CT and SMA are presented in the light of clinical and embryological information. The celiac axises of a total of 30 adult corpses were examined. Dissections of abdominal region were performed in detail according to Cunningham’s manual. Angiographic images of 100 consecutive adult patients who underwent celiac MDCT angiography were evaluated. During autopsies, an incomplete celiac trunk or bifurcation of celiac trunk associated with the hepatomesenteric and gastrosplenic trunks (0.7%) and a celiacomesenteric trunk associated with high origin superior mesenteric artery and gastrosplenic trunk were detected (0.7%). During MDCT angiography, a case of total absence of celiac trunk associated with a hepatosplenomesenteric trunk (0.7%) and also a case of total absence of celiac trunk alone were observed (0.7%). The persistence or unusual development of ventral splanchnic arteries (VSAs) or ventral longitudinal anastomosis may result in variations or the unusual trunks related to celiac axis and SMA. The anomalous trunks of the CT may be result of either the persistence of some parts of the VSAs or ventral longitudinal anastomose that normally disappear or disappearance of parts that normally persist. The prevalence of unusual trunks of celiac axis and SMA in this study is quite low in literature. These abnormal vessels pose problems for surgeons and radiologists. Such vascular anomalies may cause clinical complications following surgical and radiological procedures such as resection of tumor of the pancreatic head, lymphadenectomy, coeliacography, aortic replacement with reimplantation of the trunk and coembolization of pancreatic and liver tumors.
基金funded by KAKENHI Number 16H02556 of the Cabinet Office,Government of Japan,the Cross-ministerial Strategic Innovation Promotion Program(SIP),“Enhancement of Societal Resiliency Against Natural Disasters”Funding was provided by the Japan Science and Technology Agency(JST)as part of the Belmont ForumThis work was supported by JST SPRING,Grant Number JPMJSP2124。
文摘Single-tree detection is one of the main research topics in quantifying the structural properties of forests. Drone Li DAR systems and terrestrial laser scanning systems produce high-density point clouds that offer great promise for forest inventories in limited areas. However, most studies have focused on the upper canopy layer and neglected the lower forest structure. This paper describes an innovative tree detection method using drone Li DAR data from a new perspective of the under-canopy structure. This method relies on trunk point clouds, with undercanopy sections split into heights ranging from 1 to 7 m, which were processed and compared, to determine a suitable height threshold to detect trees. The method was tested in a dense cedar plantation forest in the Aichi Prefecture, Japan, which has a stem density of 1140 stems·ha^(-1) and an average tree age of 42 years. Dense point cloud data were generated from the drone Li DAR system and terrestrial laser scanning with an average point density of 5000 and 6500 points·m^(-2), respectively. Tree detection was achieved by drawing point-cloud section projections of tree trunks at different heights and calculating the center coordinates. The results show that this trunk-section-based method significantly reduces the difficulty of tree detection in dense plantation forests with high accuracy(F1-Score=0.9395). This method can be extended to different forest scenarios or conditions by changing section parameters.
基金supported by the National Natural Science Foundation of China (Nos. 32260285, 31860134, 32160367, 31800469)the Third Xinjiang Scientific Expedition and Research Program (Nos2022xjkk0301, 2021xjkk14002)+1 种基金the Youth Innovation Promotion Association of the Chinese Academy of Sciences (No. 2022445)the Tianchi Doctor Program of Xinjiang Autonomous Region (No.Y970000362)。
文摘Background: Trunk volume(Vt) is an essential parameter for estimating forest stand volume, biomass, and carbon sequestration potential. As the dominant tree species in desert riparian forests, Euphrates poplar(Populus euphratica) has a high proportion of irregularly shaped tree trunks along the Tarim River, NW China, where the habitat is very fragile owing to long-term water stress. This causes uncertainty in estimation accuracy as well as technical challenges for forest surveys. Our study aimed to acquire P. euphratica Vtusing terrestrial laser scanning(TLS) and to establish a species-specific Vtprediction model.Methods: A total of 240 individual trees were measured by TLS multiple-station in 12 sampling plots in three sections along the lower reaches of the Tarim River. Vtwas calculated by a definite integration method using trunk diameters(Di) at every 0.1-m tree height obtained from TLS, and all data were split randomly into two sets:70% of data were used to estimate the model parameter calibration, and the remaining 30% were used for model validation. Sixteen widely used candidate tree Vtestimation models were fitted to the TLS-measured Vtand tree structural parameter data, including tree height(H), diameter at breast height(DBH), and basal diameter(BD). All model performances were evaluated and compared by the statistical parameters of determination coefficient(R^(2)),root mean square error(RMSE), Bayesian information criterion(BIC), mean prediction error(ME), mean absolute error(MAE), and modeling efficiency(EF), and accordingly the best model was selected.Results: TLS point cloud reflection intensity(RI) has advantageous in the extraction of data from irregular tree trunk structures. The P. euphratica tree Vtvalues showed obvious differences at the same tree height(H). There was no significant correlation between Vtand H(R^(2)=0.11, P < 0.01), which reflected the irregularity of P. euphratica trunk shape in the study area. Among all the models, model(14): Vt=0.909DBH1.184H0.487BD0.836(R^(2)=0.97, RMSE=0.14) had the best prediction capability for irregularly shaped Vtwith the highest R^(2), BIC(-37.96), and EF(0.96), and produced a smaller ME(0.006) and MAE(1.177) compared to other models. The prediction accuracy was 93.18%.Conclusions: TLS point cloud RI has a potential for nondestructively measuring irregularly shaped trunk structures of P. euphratica and developed Vtprediction models. The multivariate models more effectively predicted Vtfor irregularly shaped trees compared to one-way and general volume models.
文摘In this study,the potential of a low-cost bio-adsorbent,taken directly from Date Palm Trunk Fibers(DPTF)agricultural wastes,for cadmium ions removal from wastewaters is examined.The performances of this adsorbent are evaluated by building breakthrough curves at different bed heights and flow rates while keeping other parameters,such as the initial feed concentration,pH,and particle size,constant.The results indicate that the maximum cadmium adsorption capacity of DTPF can be obtained from the Thomas model as 51.5 mg/g with the most extended mass transfer zone of 83 min at the lowest flow rate at 5 ml/min.The saturation concentrations(NO)and the rate constant(kab)obtained from the BDST(bed depth service time)model are 7022.16 mg/l and 0.0536 l/mg.min,respectively.Using the Yon-Nelsen Model,it is found that operating at a lower flow rate leads to a larger value of the elapsed needed time to reach a 50%breakthrough.The Wolborska model indicates that the bed capacity increases with decreasing the flow rate,and the adsorbent can achieve a greater external mass transfer kinetic coefficient(2.271/min)at a higher flow rate.
文摘Objective: The purpose of this study was to clarify the relationship between respiratory muscle strength and skeletal muscle mass (trunk, upper limbs, and lower limbs) in older people who were certified as requiring nursing or supportive care. Methods: Thirty-five older people (65 years or older) who were certified as requiring nursing care or support were included in the study. The subjects were divided into a non-sarcopenic group (n = 12) and a sarcopenic group (n = 23) according to the sarcopenia diagnostic criteria proposed by the Asian Working Group for Sarcopenia. Maximum inspiratory pressure, maximum expiratory pressure, skeletal muscle mass (trunk, upper and lower limbs), and hand grip strength were measured. Pearson’s correlation coefficient and multiple regression analysis were used for statistical processing. Results: In the non-sarcopenic group, both expiratory muscle strength and hand grip strength were correlated with skeletal muscle mass. In the sarcopenia group, expiratory muscle strength was not correlated with skeletal muscle mass, and only hand grip strength was correlated with upper limb muscle mass. Multiple regression analysis revealed that, in the non-sarcopenic group, trunk muscle mass was the primary factor in expiratory muscle strength and upper limb muscle mass was the primary factor in hand grip strength. In the sarcopenia group, upper limb muscle mass was found to be the main factor in hand grip strength. Conclusion: Our results highlight the importance of assessing expiratory muscle strength and trunk muscle mass before sarcopenia develops in older people who require support and nursing care.
文摘Trunk function has been identified as an important early predictor of functional outcome after stroke and the same deteriorates on both contralateral and ipsilateral sides of the body following stroke. The primary contribution of the trunk muscles is to allow the body to remain upright, adjust weight shifts, and control movements against constant pull of gravity and is considered central key point of the body. Proximal stability of the trunk is a pre-requisite for distal limb mobility, balance, gait and functional activities and its positive correlation in hemiplegia has been demonstrated in a cross- sectional study. Both isokinetic and handheld dynamometer muscle strength testing demonstrated the weakness of bilateral trunk flexors, extensors and rotator muscles in both acute and chronic hemiplegic patients. This was confirmed by electromyography analysis which identified poor bilateral trunk muscles activity in patients with stroke. Trunk impairment scale is sensitive to evaluate the selective muscle control of upper and lower trunk, and it has been reported that lateral flexion of the trunk is easier than rotation of the trunk and the clinical observation concurs to the difficulty in lower trunk rotation of stroke patients. However, trunk exercises given early after stroke could produce enhanced balance performance post- stroke. This review attempts to report the evidence supporting the involvement of the trunk and its influence on balance and functional performance in post-stroke hemiplegia.
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.
