脑白质高信号与上下肢运动功能障碍的相关性研究

doi:10.3969/j.issn.1006-7795.2021.03.007

首都医科大学学报 ›› 2021, Vol. 42 ›› Issue (3): 385-390.doi: 10.3969/j.issn.1006-7795.2021.03.007

脑白质高信号与上下肢运动功能障碍的相关性研究

侯雨桐, 杨淑娜, 李悦, 李譞婷, 胡文立^*

首都医科大学附属北京朝阳医院神经内科,北京 100020

收稿日期:2021-03-17 出版日期:2021-06-21 发布日期:2021-06-16
通讯作者: *E-mail:wenlihu3366@126.com

White matter hyperintensities are related to functional disturbance of upper and lower extremities

Hou Yutong, Yang Shuna, Li Yue, Li Xuanting, Hu Wenli^*

Department of Neurology, Beijing Chaoyang Hospital, Capital Medical University, Beijing 100020, China

Received:2021-03-17 Online:2021-06-21 Published:2021-06-16
Contact: *E-mail:wenlihu3366@126.com

摘要/Abstract

摘要： 目的脑白质高信号(white matter hyperintensities, WMH)作为脑小血管病(cerebral small vessel disease, cSVD)的影像学特征之一,已经被证明与步态障碍相关,而针对其对上肢运动功能影响的研究较少。本研究旨在探究WMH与上肢及下肢运动功能障碍的相关性。方法本研究连续入组首都医科大学附属北京朝阳医院神经内科查体的受试者,收集其临床资料并对其进行头部磁共振成像(magnetic resonance imaging, MRI)检查。根据Fazekas评分将受试者分为WMH低负担组(0~2分)和WMH中-高负担组(3~6分)。通过4米步行、起立行走(Timed Up and Go, TUG)测试、简易体能测试量表(Short Physical Performance Battery, SPPB)以及Tinetti平衡与步态量表评估下肢功能;用 10次双手轮替、10次手指捏合以及10次双手握拳时间评估上肢功能。采用单因素以及多因素线性回归探究WMH和上下肢运动功能之间的相关性。结果入选的256名受试者平均年龄为(61.6±10.1)岁。其中WMH低负担组172人(67.2%),中-高负担组84人(32.8%)。多因素线性回归分析在校正年龄、性别、身高、血管危险因素以及其他cSVD分型后,WMH中-高负担组受试者的步宽增宽(β=1.174,P=0.021)和步频增加(β=0.533,P=0.022),与步长和步速无关(β=-1.550,P=0.228;β=0.062,P=0.429)。WMH中-高负担组的受试者Tinetti得分以及SPPB试验得分明显低于低负担组(β=-1.127,P=0.000;β=-0.844,P=0.000),TUG试验用时也明显增加(β=1.518,P=0.000)。10次双手轮替、捏合以及手运动用时WMH中-高负担组也明显增加(β=0.635,P=0.021;β=0.962,P=0.000;β=0.518,P=0.020)。结论严重WMH会造成上肢以及下肢运动功能的障碍,导致运动功能下降。对于探究WMH导致运动功能障碍的机制有一定价值。

关键词: 运动功能障碍, 白质高信号, 上肢运动功能, 步态

Abstract: Objective To investigate the relationship between white matter hyperintensity(WMH), a common marker of cerebral small vessel disease, and functional disturbance of upper and lower extremities. Methods Totally 256 participants from Department of Neurology, Beijing Chaoyang Hospital, Capital Medical University who underwent magnetic resonance imaging (MRI)were recruited in this cross-sectional study.According to total Fazekas scores they were divided into low WMH burden group(0-2 points) and medium-high WMH burden group(3-6 points). Gait was assessed by 4 metre walkway, Timed Up and Go(TUG)test, Short Physical Performance Battery(SPPB)test and Tinetti test. Upper extremities function was evaluated with 10-repeat pronation-supination time, 10-repeat finger-tapping time and 10-repeat open and close hands time.Univariate and multivariate line regression were used to detect the correlation between function of upper and lower extremities and WMH. Results The mean age of the participants was (61.6±10.1)years. 172(67.2%)were with low WMH burden, while 84(32.8%)with medium-high WMH burden. The multivariable linear regression analyses were performed after adjustments for gender, age, height, vascular risk factors and coexisting markers of cerebral small vessel disease(cSVD).The stride width(β=1.174,P=0.021)and cadence(β=0.533,P=0.022)were correlated with the severity of the WMH, not step length and velocity (β=-1.550,P=0.228;β=0.062,P=0.429). We also found that the participants had lower Tinetti and SPPB score(β=-1.127,P=0.000;β=-0.844,P=0.000)and needed more time to achieve TUG (β=1.518,P=0.000) in medium-high WMH burden group.There were significant differences in 10-repeat pronation-supination time, 10-repeat finger-tapping time and 10-repeat open and close hands time between medium-high WMH burdenand low WMH burden (β=0.635,P=0.021;β=0.962,P=0.000;β=0.518,P=0.020). Conclusions Our study suggested that gait disturbances and upper extremities disorders were related with medium-high WMH burden. It may be helpful to explore the mechanism ofmovement disorder resulting from WMH.

Key words: movement disorder, white matter hyperintensities, upper extrenities, gait

中图分类号:

R741

侯雨桐, 杨淑娜, 李悦, 李譞婷, 胡文立. 脑白质高信号与上下肢运动功能障碍的相关性研究[J]. 首都医科大学学报, 2021, 42(3): 385-390.

Hou Yutong, Yang Shuna, Li Yue, Li Xuanting, Hu Wenli. White matter hyperintensities are related to functional disturbance of upper and lower extremities[J]. Journal of Capital Medical University, 2021, 42(3): 385-390.

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脑白质高信号与上下肢运动功能障碍的相关性研究

White matter hyperintensities are related to functional disturbance of upper and lower extremities

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