@article {Lin10.1212 / WNL。0000000000207417,作者={大卫J林和理查德玉石和朱莉·迪卡洛和悉尼麦基尔南和塞缪尔·B·施奈德和汉娜雅各布斯和金伯利话务量和凯利Rishe皮尔斯博因河和杰夫·戈德史密斯和杰西卡Ranford Seth p Finklestein和李h . Schwamm业务和利R和史蒂文·c·克莱默},title ={区分不同的近端和远端神经系统急性中风后上肢运动控制},elocation-id = {10.1212 / WNL。={2023}0000000000207417},年,doi = {10.1212 / WNL。出版商0000000000207417}= {Wolters Kluwer健康,公司代表美国神经病学学会},抽象={背景和目标:经典和奇异的模式远比近端上肢急性中风后电动机赤字并不占不同的结构和首页功能组织的近端和远端电动机控制电路健康的中枢神经系统。我们假设单独的近端和远端上肢急性中风后临床症状可能是杰出的,模式的神经解剖学的损伤导致这两个症状会反映出他们不同的组织完整的中枢神经系统。运动损伤的方法:近端和远端组件(上肢Fugl-Meyer分数)和力量(肩膀绑架手指扩展分数)在连续评估招募病人急性中风的7天之内。偏相关分析用于评估近端和远端运动成绩之间的关系。功能测试结果包括盒子\ &街区,Barthel指数和改良Rankin规模检查与近端和远端运动模式的赤字。分布lesion-symptom映射是用于识别损伤相关的近端和远端上肢运动赤字。结果:共有141个连续的患者(49 \ %女)评估4.0 {\ textpm} 1.6(平均{\ textpm} SD)天后中风发病。单独的近端和远端上肢运动组件区分急性中风后(p = 0.002)。近端远端损伤(即多模式。,相对保存远端电动机控制)并不罕见,在23 \ %急性中风的主题。 Patients with relatively preserved distal motor control, even after controlling for total extent of deficit, had better outcomes in the first week and at 90-days post-stroke (Box and Block Test, ρ = 0.51, p \< 0.001; Barthel Index, ρ = 0.41, p \< 0.001; modified Rankin Scale, ρ = 0.38, p \< 0.001). Deficits in proximal motor control were associated with widespread injury to subcortical white and gray matter, while deficits in distal motor control were associated with injury restricted to the posterior aspect of the precentral gyrus, consistent with the organization of proximal versus distal neural circuits in the healthy CNS.Conclusions: These results highlight that proximal and distal upper extremity motor systems can be selectively injured by acute stroke, with dissociable deficits and functional consequences. Our findings emphasize how disruption of distinct motor systems can contribute to separable components of post-stroke upper extremity hemiparesis.}, issn = {0028-3878}, URL = {//www.ez-admanager.com/content/early/2023/06/02/WNL.0000000000207417}, eprint = {//www.ez-admanager.com/content/early/2023/06/02/WNL.0000000000207417.full.pdf}, journal = {Neurology} }