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Outcome prediction of stroke patients: magnetic resonance brain imaging and rehabilitation nutrition

Research Project

Project/Area Number 16H03209
Research Category

Grant-in-Aid for Scientific Research (B)

Allocation TypeSingle-year Grants
Section一般
Research Field Rehabilitation science/Welfare engineering
Research InstitutionHyogo Medical University

Principal Investigator

Koyama Tetsuo  兵庫医科大学, 医学部, 特別招聘教授 (40538237)

Co-Investigator(Kenkyū-buntansha) 道免 和久  兵庫医科大学, 医学部, 教授 (50207685)
内山 侑紀  兵庫医科大学, 医学部, 講師 (50725992)
Project Period (FY) 2016-04-01 – 2021-03-31
Project Status Completed (Fiscal Year 2020)
Budget Amount *help
¥17,420,000 (Direct Cost: ¥13,400,000、Indirect Cost: ¥4,020,000)
Fiscal Year 2020: ¥2,080,000 (Direct Cost: ¥1,600,000、Indirect Cost: ¥480,000)
Fiscal Year 2019: ¥1,690,000 (Direct Cost: ¥1,300,000、Indirect Cost: ¥390,000)
Fiscal Year 2018: ¥3,380,000 (Direct Cost: ¥2,600,000、Indirect Cost: ¥780,000)
Fiscal Year 2017: ¥3,380,000 (Direct Cost: ¥2,600,000、Indirect Cost: ¥780,000)
Fiscal Year 2016: ¥6,890,000 (Direct Cost: ¥5,300,000、Indirect Cost: ¥1,590,000)
Keywords脳卒中 / 脳画像 / 機能 / 予測 / 帰結 / 核磁気共鳴 / 上肢 / 下肢 / 認知 / 栄養 / 画像診断 / 予後 / MRI / 補正 / アーチファクト / 画像 / リハビリテーション
Outline of Final Research Achievements

The prediction of outcome is important when planning appropriate rehabilitation for stroke patients. Magnetic resonance diffusion tensor imaging (DTI), which enables quantitative evaluation of neural-fiber damage within the brain, is potentially useful to predict outcomes including upper and lower extremity functions, and cognitive functions and activities of daily living. Based on DTI data obtained at 2-3 weeks post stroke, neural-fiber damage was evaluated. Outcome measurements were obtained at 3-6 months poststroke. The correlations between the neural-fiber damage and outcomes were then assessed. Neural-fiber damages in the corticospinal tracts correlated with upper and lower extremity functions and activities of daily living, whereas those in the superior longitudinal tracts correlated with cognitive functions. The findings suggest that DTI can be clinically useful when predicting outcomes of stroke patients.

Academic Significance and Societal Importance of the Research Achievements

脳卒中は患者数が多く、本邦で要介護状態となる主要な疾患である。これらの患者に、公的医療保険・介護保険を用いたリハビリテーションが行われている。効率のよいリハビリテーションを提供するために、どの程度の回復がみこまれるのか、すなわち予後予測を立てることが重要である。しなしながら、医療や介護の現場でこれまで、科学的根拠に裏付けられた予後予測の手法は多くなかった。MRIは本邦の脳卒中医療で日常的に用いられている。本研究は、拡散テンソル法MRIを用いて、科学的裏付けのある脳卒中の予後予測法を確立した。本研究の知見により、日常診療レベルで、定量的手法の予後予測法が普及することが期待される。

Report

(6 results)
  • 2020 Annual Research Report   Final Research Report ( PDF )
  • 2019 Annual Research Report
  • 2018 Annual Research Report
  • 2017 Annual Research Report
  • 2016 Annual Research Report
  • Research Products

    (27 results)

All 2021 2020 2019 2018 2017 2016

All Journal Article (6 results) (of which Peer Reviewed: 6 results,  Open Access: 3 results) Presentation (21 results) (of which Int'l Joint Research: 3 results,  Invited: 10 results)

  • [Journal Article] Outcome prediction for patients with ischemic stroke in acute care: new three-level model by eating and bladder functions2021

    • Author(s)
      Uchida K., Uchiyama Y., Domen K. and Koyama T.
    • Journal Title

      Ann. Rehabil. Med.

      Volume: 45

    • Related Report
      2020 Annual Research Report
    • Peer Reviewed / Open Access
  • [Journal Article] Item difficulties of the FIM-motor subscale in patients with ischemic stroke during acute care: An Ordinal Logistic Modeling Study2020

    • Author(s)
      Uchida K., Uchiyama Y., Domen K. and Koyama T.
    • Journal Title

      Prog. Rehabil. Med.

      Volume: 5 Issue: 0 Pages: 20200022-20200022

    • DOI

      10.2490/prm.20200022

    • NAID

      130007919012

    • Related Report
      2020 Annual Research Report
    • Peer Reviewed / Open Access
  • [Journal Article] Outcome in Stroke Patients Is Associated with Age and Fractional Anisotropy in the Cerebral Peduncles: A Multivariate Regression Study2020

    • Author(s)
      Koyama T., Uchiyama Y. and Domen K.
    • Journal Title

      Progress in Rehabilitation Medicine

      Volume: 5 Issue: 0 Pages: n/a

    • DOI

      10.2490/prm.20200006

    • NAID

      130007828600

    • ISSN
      2432-1354
    • Related Report
      2020 Annual Research Report
    • Peer Reviewed / Open Access
  • [Journal Article] Comparison of fractional anisotropy from tract-based spatial statistics with and without lesion masking in patients with intracerebral Hemorrhage: a technical note2019

    • Author(s)
      Tetsuo Koyama, Yuki Uchiyama, Kazuhisa Domen
    • Journal Title

      Journal of stroke and cerebrovascular diseases

      Volume: 28 Issue: 11 Pages: 104376-104376

    • DOI

      10.1016/j.jstrokecerebrovasdis.2019.104376

    • Related Report
      2019 Annual Research Report
    • Peer Reviewed
  • [Journal Article] Associations of diffusion-tensor fractional anisotropy and FIM outcome assessments after intracerebral hemorrhage2018

    • Author(s)
      Tetsuo Koyama, Yuki Uchiyama, Kazuhisa Domen
    • Journal Title

      Journal of stroke and cerebrovascular diseases

      Volume: 27 Issue: 10 Pages: 2869-2876

    • DOI

      10.1016/j.jstrokecerebrovasdis.2018.06.012

    • Related Report
      2018 Annual Research Report
    • Peer Reviewed
  • [Journal Article] Utility of fractional anisotropy in cerebral peduncle for stroke outcome prediction: comparison of hemorrhagic and ischemic strokes2018

    • Author(s)
      Tetsuo Koyama, Masatoshi Koumo, Yuki Uchiyama, Kazuhisa Domen
    • Journal Title

      Journal of stroke and cerebrovascular diseases

      Volume: 27 Issue: 4 Pages: 878-885

    • DOI

      10.1016/j.jstrokecerebrovasdis.2017.10.022

    • Related Report
      2017 Annual Research Report
    • Peer Reviewed
  • [Presentation] 脳出血患者におけるDTI-FA TBSS 解析の病変マスキンク有無の比較:日常臨床での有用性2021

    • Author(s)
      小山哲男、道免和久
    • Organizer
      第46回日本脳卒中学会学術集会
    • Related Report
      2020 Annual Research Report
  • [Presentation] 脳画像解析とリハ栄養-簡単な脳の見かた-2020

    • Author(s)
      小山哲男
    • Organizer
      第10回日本リハビリテーション栄養学会学術集会
    • Related Report
      2020 Annual Research Report
    • Invited
  • [Presentation] 脳出血患者におけるDTI-FA TBSS 解析の病巣マスク適応/非適応の比較:マスク非適応TBSSの臨床的有用性2020

    • Author(s)
      小山哲男、内山侑紀、道免和久
    • Organizer
      第22回ヒト脳機能マッピング学会
    • Related Report
      2020 Annual Research Report
  • [Presentation] 脳梗塞患者の帰結とDTI-FA値の関連-皮質脊髄路、上縦束、下縦束、鈎状束の多変量解析-2020

    • Author(s)
      小山哲男、道免和久
    • Organizer
      第45回日本脳卒中学会学術集会
    • Related Report
      2020 Annual Research Report
  • [Presentation] 脳出血例のDTI-FAと帰結の関連-皮質脊髄路、上縦束、下縦束、鈎状束の多変量解析-2020

    • Author(s)
      小山哲男
    • Organizer
      第11回日本ニューロリハビリテーション学会学術集会
    • Related Report
      2020 Annual Research Report
  • [Presentation] Association of diffusion-tensor fractional anisotropy and outcome assessments after cerebral infarction2019

    • Author(s)
      Tetsuo Koyama, Yuki Uchiyama, Kazuhisa Domen
    • Organizer
      The 13th International Society of Physical and Rehabilitation Medicine
    • Related Report
      2019 Annual Research Report
    • Int'l Joint Research
  • [Presentation] 拡散テンソル法脳MRIによる機能予後評価・帰結予測2019

    • Author(s)
      小山哲男
    • Organizer
      第56回日本リハビリテーション医学会学術集会
    • Related Report
      2019 Annual Research Report
    • Invited
  • [Presentation] Clinical applicability of TBSS without Lesion Masking in Patients with intracerebral hemorrhage2019

    • Author(s)
      小山哲男、道免和久
    • Organizer
      第3回ヒト脳イメージング研究会
    • Related Report
      2019 Annual Research Report
  • [Presentation] 脳卒中患者の機能予後予測・帰結予測2019

    • Author(s)
      小山哲男
    • Organizer
      第68回日本リハビリテーション医学会近畿地方会教育研修会
    • Related Report
      2019 Annual Research Report
    • Invited
  • [Presentation] 脳卒中患者の予後予測:拡散テンソル法MRI脳画像による片麻痺、FIMスコアの予測2019

    • Author(s)
      小山哲男
    • Organizer
      日本リハビリテーション医学会 北海道地方会 専門医・認定臨床医生涯教育研修会
    • Related Report
      2018 Annual Research Report
    • Invited
  • [Presentation] シンポジウム3「脳機能・病態から見た脳卒中画像診断の最前線」 DTIによる機能予後評価・帰結予測2019

    • Author(s)
      小山哲男
    • Organizer
      第44回日本脳卒中学会学術集会
    • Related Report
      2018 Annual Research Report
    • Invited
  • [Presentation] Associations of diffusion-tensor fractiona anisotropy and outcome assessments after cerebral infarction2018

    • Author(s)
      Tetsuo Koyama, Yuki Uchiyama, Kazuhisa Domen
    • Organizer
      第2回ヒト脳イメージング研究会
    • Related Report
      2018 Annual Research Report
  • [Presentation] The relationships between diffusion-tensor fractional anisotropy within cerebral peduncle and outcomes among patients with hemiparesis due to cerebral infarction2018

    • Author(s)
      Tetsuo Koyama, Yuki Uchiyama, Kazuhisa Domen
    • Organizer
      The 12th International Society of Physical and Rehabilitation Medicine World Congress
    • Related Report
      2018 Annual Research Report
    • Int'l Joint Research
  • [Presentation] 脳卒中患者の予後予測 -拡散テンソル法MRI脳画像を使って-2018

    • Author(s)
      小山哲男
    • Organizer
      第55回日本リハビリテーション医学会学術集会
    • Related Report
      2018 Annual Research Report
    • Invited
  • [Presentation] 脳出血患者のFIM運動項目帰結予測:大脳脚DTI-FAと年齢による2変数モデル2018

    • Author(s)
      小山哲男、内山有紀、道免和久
    • Organizer
      第55回日本リハビリテーション医学会学術集会
    • Related Report
      2018 Annual Research Report
  • [Presentation] Utility of fractional anisotropy in cerebral peduncle for predicting outcomes of hemorrhagic and ischemic strokes2018

    • Author(s)
      Tetsuo Koyama, Yuki Uchiyama, Kazuhisa Domen
    • Organizer
      第55回日本リハビリテーション医学会学術集会
    • Related Report
      2018 Annual Research Report
  • [Presentation] 脳卒中予後診断~二足歩行、上肢機能、言語機能~2017

    • Author(s)
      小山哲男
    • Organizer
      第60回日本リハビリテーション医学会近畿地方会生涯教育研修会
    • Related Report
      2017 Annual Research Report
    • Invited
  • [Presentation] 脳卒中患者の帰結予測 -ADL、拡散テンソル法MRI、自宅復帰-2017

    • Author(s)
      小山哲男
    • Organizer
      日本リハビリテーション医学会第1回秋期学術集会
    • Related Report
      2017 Annual Research Report
    • Invited
  • [Presentation] 脳卒中予後診断 ~二足歩行、上肢機能、言語機能~2017

    • Author(s)
      小山哲男
    • Organizer
      日本リハビリテーション医学会近畿地方会 第60回専門医・認定臨床医生涯教育研修会
    • Place of Presentation
      兵庫医科大学(兵庫県・西宮市)
    • Related Report
      2016 Annual Research Report
    • Invited
  • [Presentation] Predictive Accuracy of the Harris-Benedict equation in patients with cerebral infarct during acute care2016

    • Author(s)
      Tetsuo Koyama, Ayano Nagano, Yoshitaka Yamada, Hiroji Miyake, Kazuhisa Domen
    • Organizer
      The 10th International Society of Physical and Rehabilitation Medicine
    • Place of Presentation
      Kuala Lumpur Convention Center, Kuala Lumpur, Malaysia
    • Year and Date
      2016-05-29
    • Related Report
      2016 Annual Research Report
    • Int'l Joint Research
  • [Presentation] 脳卒中患者の予後予測2016

    • Author(s)
      小山哲男
    • Organizer
      福岡県作業療法士協会 身体分野研修会
    • Place of Presentation
      聖マリア学院大学(福岡県・久留米市)
    • Related Report
      2016 Annual Research Report
    • Invited

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Published: 2016-04-21   Modified: 2022-01-27  

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