% % 0期刊文章%珍妮特Plantin马里昂Verneau %艾莉森·k·Godbolt %一个盖亚瓦伦Pennati % Evaldas Laurencikas % Birgitta约翰逊%莉娜Krumlinde-Sundholm %特里大亨% (Jorgen Borg %帕维尔·g·林德伯格% T恢复和预测卒中后用双手的手使用% D R 10.1212 / WNL 2021%。0000000000012366 % J首页神经病学% P e706-e719 % V 97% N 7% X目的确定复苏的主要预测因子的相似点和不同点的用双手的手使用和unimanual卒中后运动障碍。方法前瞻性纵向研究,89年首次中风患者手臂麻痹性痴呆是评估在3周和中风发作后3个月和6个月。用双手的活动性能评估与成人协助评估中风(Ad-AHA),并与Fugl-Meyer unimanual运动损伤评估评估(FMA)。候选人预测因子包括肩绑架和手指扩展以相应的菲利普-马萨项(FMA-SAFE;范围0 - 4)和感官和认知障碍。MRI是用来测量加权皮质脊髓束损伤负载(wCST-LL)和静止状态两半球间的功能连通性(FC)。结果初始Ad-AHA性能很差但是改善随着时间的推移,在所有(mild-severe)损伤子组。在每个时间点Ad-AHA与菲利普-马萨(r > 0.88, p < 0.001),和恢复轨迹是相同的。中度到重度的患者最初的菲利普-马萨,FMA-SAFE得分是最强的预测Ad-AHA结果(R2 = 0.81)和程度的恢复(R2 = 0.64)。两点歧视额外解释方差Ad-AHA结果(R2 = 0.05)。重复分析没有FMA-SAFE分数确认wCST-LL和认知障碍是额外的预测因子。wCST-LL > 5.5立方厘米强烈预测低最小FMA / Ad-AHA恢复(≤10到20分分别特异性= 0.91)。 FC explained some additional variance to FMA-SAFE score only in unimanual recovery.Conclusion Although recovery of bimanual activity depends on the extent of corticospinal tract injury and initial sensory and cognitive impairments, FMA-SAFE score captures most of the variance explained by these mechanisms. FMA-SAFE score, a straightforward clinical measure, strongly predicts bimanual recovery.ClinicalTrials.gov Identifier NCT02878304.Classification of Evidence This study provides Class I evidence that the FMA-SAFE score predicts bimanual recovery after stroke.Ad-AHA=Adult Assisting Hand Assessment Stroke; BNIS=Barrow Neurological Institute Screen for Higher Cerebral Functions; CST=corticospinal tract; FC=functional connectivity; FMA=Fugl-Meyer Assessment; FMA-Hand=FMA for the hand; FMA-SAFE=FMA for shoulder abduction and finger extension; FMA-UE=FMA for the upper extremity; PCG=precentral gyrus; ROC=receiver operating characteristic; ROI=region of interest; SMA=supplementary motor area; 2pD=2-point discrimination; wCST-LL=weighted CST lesion load %U //www.ez-admanager.com/content/neurology/97/7/e706.full.pdf