The Correlation of Motor Impairment and Fractional Anisotropy in Diffusion Tensor Imaging in Post-stroke Hemiplegic Patients

OBJECTIVE: Diffusion tensor imaging (DTI) fully characterizes water molecule mobility, allowing an exploration of fiber tract integrity and orientation in the human brain. The purpose of this study was to investigate the correlation between motor impairment and the changes of fractional anisotropy (FA) in the internal capsule in post-stroke hemiplegic patients. METHOD: Six normal subjects and 19 post-stroke hemiplegic patients who had a lesion in the internal capsule were included in this study. DTI was performed with a 3.0 Tesla MR at the mean interval of 28.2 days after stroke. Motor impairment was assessed with the Motricity Index and Trunk Control Test at the time of the imaging study. FA was measured in anterior limb and posterior limb of internal capsule. RESULTS: FA reduced significantly in the affected region compared with the other unaffected region in patients and normal region in controls. FA in the affected posterior limb of the internal capsule was correlated with the Motricity Index score of the affected upper limb (r=0.642, p<0.05). CONCLUSION: DTI can be helpful to evaluate motor impairment of the upper limb in post-stroke hemiplegic patients.

Prevalence of Autoimmune Thyroid Disease and Correlation Between Thyroid Autoantibody and Acetylcholine Receptor Antibody in Myasthenia Gravis Patients / 대한내분비학회지

BACKGROUND: There were several reports that thyroid autoimrnune disease commonly found in myasthenia gravis patients. We performed this study to determine the prevalence of thyroid autoimmune disease as well as analyze correlation between acetylcholine receptor antibody and various thyroid autoantibadies among the myasthenia gravis patients in Korea. METHOD: The patient group, 48 patients, diagnosed as myasthenia gravis from January 1985 to December 1995 at the department of Neurology, Internal medicine at Dongsan Medical Center was compaired to the control group, 40 patients, with no age and sex difference from the patient group. The samples were collected from both group for the measure of the values of acetylcholine receptor antibody, thyroid autoantibody and thyroid hormones. RESULT: 1) The values of acetylcholine receptor antibody in myasthenia gravis group and control group were 5.78+-0.7nM and 0.05+-0.06nM respectively. Of 48 patients with myasthenia gravis, 38 patients have been measured acetylcholine receptor antibody value > 0.5nM, Their mean average value was 7.24+-0.66nM. 2) The severe myasthenia gravis group with value of acetylcholine receptor antibody 0.5nM and severe myasthenia gravis group with value of acetylcholine receptor antibody 0.5nM showed thyroglobulin antibody value of 159.6+-79.91IU/mL versus 56.86+-32.99IU/mL. also thyroid microsomal antibody value showed 159.0+-79.9IU/mL and 23.633+-0.19IU/mL respectively. 3) Of 48 myasthenia gravis patients, 12 patients (24%) had high value of antithyroglobulin antibody or anti-microsomal antibody and 5 patients (10%) had both antibodies at the same times. In contrast, only 3 patients (8%) were observed with high value of either one of antibodies. Patient with both antibodies was not observed in normal control group. CONCLUSION: According to the datas we have obtained, appearence of the thyroid autoantibody is significantly greater in severe myasthenia gravis group than normal control group. Therefore it is suggested that the prevalence of thyroid autoimmune disease is higher in severe myasthenia gravis group than mild myasthenia gravis group or normal control group.

ITP Associated with Guillain-Barre Syndrome

Idiopathic thrombocytopenic purpura (ITP) is a disorder caused by the interaction of IgG and other antibodies with the antigen on platelet surface. ITP associated with Guillain-Barre syndrome has been reported rarely to occur in the same patient simultaneously. We presented a young male patient who had acute ITP and Guillain-Barre syndrome at the same time. This case was interesting because IgG might play a prominent role in the development of ITP and Guillain-Barre syndrome. It has been suggested that humoral immune mechanism play a role in the development of Guillain-Barre syndrome.