Preliminary Exploration Of The Relationship Between The Syndrome Elements Of Ischemic Stroke In The Acute Phase And The Lesion Imaging

Objective:In order to explore the correlation between traditional Chinese medicine(TCM)syndrome elments in the acute stage of ischimc stroke and lesion imaging,this project uses voxel-based lesion-symptom mapping(VLSM)provided by LESYMAP which is written by R language and explains this matter in voxel level.It is different from previous studies that explained the correlation between TCM syndrome type of ischimc stroke and imaging in view of lesion location,lesion volume and lesion number.This project may provide an imaging basis for TCM syndrome differentation of stroke and make imaging an extension of TCM diagnosis.Methods:Acorrding to the inclusion and exclusion criteria,49 patients were included who were admitted to the first department of Encephalogy,Dongzhimen Hospital of BeiJing University of Chinese Medicine from May 2018 to December 2019.Relevent data of patients were collected on the day of admission.All patients were evaluated by TCM syndrome elements diagnosis,syndrome elements quantification score,National Institute of Health Stroke Scale(NHISS)and Bathel Index.And all patients were scanned by MRI.Different softwares were used to process different data.Statistical analysis of macro data were processed by Excel2013 and SPSS24.0.MATLAB2016b,TurtleSeg and Rstudio3.6.2 were used to preprocess MRI and compute correlation between syndrome scores and voxels.Results:1.This research collected 49 patients with acute ischmic stroke,including 34 males and 15 females.The proportion of male was significantly higher than that of female,and the age of onset was mainly in the 50-70 years old.2.There were no significant difference in the probability of syndrome elements between groups of lesion in different number,volume,location after statiscal analysis.The quantitative scores of wind were positively correlated with the lesion volume,and the result were statistically significant(P<0.05).There was no significant correlation among the number of syndrome elements combination,the lesion location and lesion volume.3.LESYMAP software were applied to analyze the correlation between syndrome elements scores and lesions.The results are as following:the voxel related to wind are distributed in the posterior limb of internal capsule,superior corona radiata,superior longitudinal fasciculus,caudate,thalamus and so on.The voxels related to the heat are distributed in anterior limb of internal capsule,Caudate.The voxels related to phlegm-dampness are distributed in the corona_radiata,superior longitudinal_fasciculus,insula,caudate and inferior frontal gyrus.The voxels related to qi-deficiency are distributed in the posterior limb of internal capsule.The voxels related to yin-deficiency are distributed in the posterior limb of internal capsule and corona radiata.There were few voxels related to xueyu and distributed in the posterior limb of internal capsule,corona radiata.Conclusion:1.The relationship between the Chinese medicine syndrome elments of ischemic stroke in the acute stage and imaging is complicated.2.The voxels related to wind are distributed in corona radiata and posterior limb of internal capsule,reflecting the common of ischemic stroke,and may be related to the fluctuation of the condition.The voxels related to phlegum-dampness are distributed in frontal lobe and basal ganglia,which maybe affected cognition.The voxels related to qi-deficiency and yin-deficiency are mainly distributed in posterior limb of internal capsule,which maybe related to prognosis.3.The correlation between the syndrome elements in the acute phase of ischemic stroke is also reflected in imaging:qi-deficiency and yin-deficiency are both deficiency syndromes of stroke,and they are adjacent to the posterior limbs of the internal capsule;the voxels that related to wind and yin-deficiency are distributed in the posterior limb of the internal capsule and corona radiate.