Clinical study of diffusion tensor tractography on brain plasticity changes after mirror therapy rehabilitation in stroke patients with hemiplegia

Objective: To study diffusion tensor tractography(DTT) on brain plasticity changes affer mirror therapy rehabilitation in stroke patients with hemiplegia. Method: Sixty elderly stroke patients with hemiplegia were collected from February 2011 to January 2012 and divided into three groups: Group Ⅰ 20 patients aged 45—54 years old. group Ⅱ 20 patients aged 55—64 years old. group Ⅲ 20 patients aged 65 to 75 years old. All patients were treated with mirror therapy for 6 weeks continuously. National institutes health staoke scale(NIHSS) was used to evaluate neurological function before and after treatment; FMA was used to evaluate upper limb motor function. Result: Fractional anisotropy(FA) values were (0.43±0.09),(0.40±0.05),(0.33±0.07) in group Ⅰ,Ⅱ,Ⅲ, respectively, and were significantly lower than those in the corresponding side of normal brain tissue (P0.05). After 6 weeks mirror therapy, FA value was (0.48±0.04), (0.44±0.02), (0.40±0.05) in the group of Ⅰ,Ⅱ,Ⅲ respectively, and were significantly higher than those before treatment (P0.05). FA values decreased with age increasing, after treatment FMA score in each group was significantly higher than that before treatment (P0.01). In DTT, there were two grades of corticospinal tracts(CST): grade 1(intact) and grade 2(compressed or displace). Patients' NIHSS score in the same group and the same CST grade after 6 weeks treatment was significantly lower than before treatment (P0.05). In each group NIHSS score of grade 2 CST was significantly higher than that of grade 1 CST. Conclusion: DTT can visually display the relation of the location of infarction lesion and the track of fiber bundle,to determine the nerve damage, and combining with mirror therapy to promote the rehabilitation of patients.