前臂截肢者残肢运动时的脑源特征：基于标准化低分辨率脑电磁断层扫描成像技术

doi:10.3969/j.issn.1006-9771.2022.08.013

摘要/Abstract

摘要：

目的采用标准化低分辨率脑电磁断层扫描成像(sLORETA)技术观察单侧前臂截肢者残肢运动时大脑神经元电活动特征,进而阐明截肢对人体大脑可塑性的影响。

方法 2019年6月至9月,选取9例右侧前臂截肢者(截肢组)和15例健全人(健全组)作为测试对象。采用便携式脑电系统分别采集两组双侧上肢在进行直臂屈伸运动时的脑电信号。比较两组在运动执行阶段时β频段(13~30 Hz)脑电信号的sLORETA脑源差异。

结果截肢组健肢执行运动任务时与健全组同侧运动时相比,大部分脑区激活的像素数量无显著性差异(|t| < 2.023, P > 0.05);残肢执行运动任务时,大脑激活最多的脑区为BA7,其次是额叶BA6和BA10;位于大脑枕叶的BA18、BA19区激活的像素数目高于健全组(|t| > 2.782, P < 0.05)。与健全组相比,残肢运动时激活的电流密度值更低(|t| > 2.012, P < 0.05),主要位于额叶皮质的BA8、BA9、BA10、BA11、BA45、BA46、BA47区以及顶叶的BA7、BA13、BA21、BA22区,但在枕叶皮质的BA17、BA19区,其激活的电流密度值更大(|t| > 2.199, P < 0.05)。

结论截肢者健肢执行上肢前臂屈伸运动时与健全人执行同一动作时的脑源激活模式相似,但其残肢在执行运动时,脑激活区域有向大脑枕区移动的特征。

关键词: 上肢截肢, 残肢运动, 脑电, 标准化低分辨率脑电磁断层扫描成像

Abstract:

Objective To observe electroencephalography (EEG) characteristics during movement of residual limbs in forearm amputees using standard low resolution brain electromagnetic tomography (sLORETA) technology.

Methods From June to September, 2019, nine right forearm amputees (amputee group) and 15 normal healthy subjects (control group) were selected. EEG signals were recorded as finishing a straight arm flexion and extension movement task of the left and right upper limbs, and the β rhythm (13 to 30 Hz) of EEG during motor execution was analyzed with sLORETA.

Results The distribution of brain activation was almost the same as the movement of ipsilateral limbs in the control group when the intact limb of amputees moved (|t| < 2.023, P> 0.05). During the stumps moving, activated voxels was the most in BA7, followed by BA6 and BA10 in the frontal lobe, while the number of activated voxels in the BA18 and BA19 of the occipital lobe was significantly higher than those in the normal group (|t| > 2.782, P < 0.05); while the normalized current density of activation was lower than that in the control group, locating in the BA8, BA9, BA10, BA11, BA45, BA46 and BA47 of the frontal cortex, and in the BA7, BA13, BA21 and BA22 of the parietal cortex (|t| > 2.012, P < 0.05), however, it was stronger in the BA17 and BA19 of occipital cortex (|t| > 2.199, P < 0.05).

Conclusion The brain activation of the amputee is similar to the healthy subjects when they moving the intact limb. However, during the movement of the stump, the activated brain regions are moving toward the posterior occipital.

Key words: forearm amputation, movement of residual limbs, electroencephalography, standard low resolution brain electromagnetic tomography

中图分类号:

R687.5

郭峰,郝莹,陈渔. 前臂截肢者残肢运动时的脑源特征：基于标准化低分辨率脑电磁断层扫描成像技术[J]. 《中国康复理论与实践》, 2022, 28(8): 972-980.

GUO Feng,HAO Ying,CHEN Yu. Brain sources characteristics during movement of residual limbs in forearm amputees based on standard low resolution brain electromagnetic tomography technology[J]. 《Chinese Journal of Rehabilitation Theory and Practice》, 2022, 28(8): 972-980.

图/表 7

表1

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图2

图3

图4

表2

表3

两组运动执行阶段大脑不同布罗德曼分区平均 sLORETA标准化电流密度单位：×10-3 μV·mm-2"

脑叶	脑回	BA	残肢运动		健肢运动		t值^a	P值^a	t值^b	P值^b
脑叶	脑回	BA	健全组	截肢组	健全组	截肢组	t值^a	P值^a	t值^b	P值^b
额叶	中央前回	BA4	3.06±2.46	2.54±1.70	1.80±1.24	1.82±0.87	0.557	0.583	-0.042	0.967
额叶	额上回、额中回	BA6	1.45±0.72	1.77±1.07	1.89±0.62	1.44±0.55	-0.869	0.394	2.096	0.056
额叶	额上回、额中回	BA8	1.98±0.45	1.41±0.41	1.91±0.86	1.84±0.74	2.884	0.009	0.203	0.841
额叶	额上回、额中回	BA9	2.16±1.35	0.96±0.48	1.41±0.79	2.38±1.02	2.552	0.018	-2.612	0.016
额叶	额上回、额中回	BA10	10.25±5.38	1.75±0.83	4.60±2.31	10.03±5.47	4.666	< 0.001	-3.408	0.003
额叶	额上回、额中回、额下回	BA11	8.62±5.50	1.61±0.97	4.04±2.58	8.85±6.02	3.756	0.001	-2.861	0.009
额叶	额中回、额下回	BA45、46、47	4.78±2.88	1.38±0.82	2.01±1.01	2.98±1.21	4.278	< 0.001	-2.016	0.056
顶叶	中央后回	BA1、2、3	1.45±0.97	1.59±1.06	1.53±0.96	1.73±0.81	-0.331	0.744	-0.444	0.661
顶叶	中央旁小叶	BA5	4.21±1.87	3.80±1.46	3.46±1.39	3.42±1.46	0.561	0.580	0.067	0.947
顶叶	顶上小叶、中央后回	BA7	5.99±1.71	4.32±1.04	4.49±2.09	4.43±2.09	2.638	0.015	0.068	0.946
顶叶	顶下小叶	BA40	2.31±0.80	1.51±0.50	1.23±0.61	1.89±0.62	2.688	0.013	-2.551	0.018
颞叶	颞中回、颞下回	BA21	4.57±2.41	2.03±1.14	2.11±0.98	3.25±0.63	2.951	0.007	-3.111	0.005
颞叶	颞上回	BA22	2.91±1.73	1.54±0.52	1.57±0.78	2.56±0.79	2.296	0.032	-2.996	0.007
边缘叶	岛叶	BA13	1.47±1.20	0.65±0.22	0.87±0.55	1.11±0.43	2.012	0.050	-2.013	0.052
边缘叶	扣带回前部	BA24	0.71±0.39	0.75±0.35	0.70±0.30	0.82±0.36	-0.252	0.803	-0.881	0.388
边缘叶	扣带回后部	BA31	1.20±0.39	1.20±0.37	0.73±0.32	1.12±0.26	0.061	0.951	-3.088	0.005
枕叶	楔叶、舌回	BA17	1.31±0.40	1.79±0.31	1.17±0.33	1.31±0.42	-3.078	0.005	-0.905	0.375
枕叶	楔叶、楔前叶、枕上回	BA18	1.50±0.71	1.88±0.63	1.26±0.60	1.34±0.62	-1.321	0.200	-0.312	0.758
枕叶	楔叶、枕中回、梭状回	BA19	2.03±1.01	2.97±1.02	1.62±0.87	1.76±0.85	-2.199	0.039	-0.385	0.704
枕叶	扣带回前部	BA32	2.27±1.63	0.63±0.45	1.17±0.66	2.24±1.93	2.928	0.008	-2.104	0.042

表3

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组别	n	年龄/岁	身高/m	体质量/kg	残疾年限/年
健全组	15	22.6±2.7	1.78±0.1	71.2±8.5
截肢组	9	24.7±8.6	1.73±0.1	64.2±16.4	13.4±5.4
t值		0.887	-1.186	-1.385
P值		0.495	0.229	0.260

脑叶	脑回	BA	残肢运动		健肢运动		t值^a	P值^a	t值^b	P值^b
脑叶	脑回	BA	健全组	截肢组	健全组	截肢组	t值^a	P值^a	t值^b	P值^b
额叶	中央前回	BA4	36±10	41±12	44±15	44±11	-1.101	0.283	0.001	0.999
额叶	额上回、额内侧回	BA6	118±26	160±44	156±38	153±33	-2.958	0.007	0.196	0.846
额叶	额上回、额中回	BA8	63±12	49±12	66±10	48±12	2.767	0.011	3.964	< 0.001
额叶	额上回、额中回	BA9	90±12	26±7	59±20	68±29	14.509	< 0.001	-0.902	0.377
额叶	额上回、额中回	BA10	178±36	74±14	134±32	143±38	8.240	< 0.001	-0.622	0.540
额叶	额上回、额中回、额下回	BA11	143±37	57±12	94±45	132±46	6.712	< 0.001	-1.987	0.060
额叶	额中回、额下回	BA45、46、47	161±53	63±15	95±34	150±45	5.376	< 0.001	-3.462	0.002
顶叶	中央后回	BA1、2、3	43±11	54±13	61±16	64±15	-2.217	0.037	-0.455	0.654
顶叶	中央旁小叶	BA5	63±16	60±15	68±17	58±12	0.455	0.654	1.670	0.074
顶叶	顶上小叶、中央后回	BA7	348±59	308±72	332±87	265±61	1.482	0.153	2.023	0.055
顶叶	顶下小叶	BA40	99±13	87±19	87±29	106±25	1.842	0.079	-1.632	0.117
颞叶	颞中回、颞下回	BA21	149±39	89±18	97±36	145±36	4.319	< 0.001	-3.162	0.005
颞叶	颞上回	BA22	83±13	47±23	45±9	91±27	4.390	< 0.001	-6.132	< 0.001
边缘叶	岛叶	BA13	41±10	10±2	19±12	30±18	9.133	< 0.001	-1.992	0.082
边缘叶	扣带回后部	BA31	25±7	36±7	17±8	16±6	3.292	0.002	0.323	0.750
枕叶	楔叶、舌回	BA17	10±2	18±5	9±3	11±2	-5.562	< 0.001	-1.770	0.091
枕叶	楔叶、楔前叶、枕上叶	BA18	73±19	102±24	59±14	53±16	-3.282	0.003	0.964	0.345
枕叶	楔叶、枕中回、梭状回	BA19	137±41	185±43	112±22	101±18	-2.782	0.012	1.264	0.219
枕叶	扣带回前部	BA32	31±7	4±1	12±4	36±10	11.401	< 0.001	-8.433	< 0.001