静息态脑电图在脑卒中患者上肢运动功能评估中的应用

doi:10.3969/j.issn.1006-9771.2025.04.010

《中国康复理论与实践》 ›› 2025, Vol. 31 ›› Issue (4): 448-457.doi: 10.3969/j.issn.1006-9771.2025.04.010

静息态脑电图在脑卒中患者上肢运动功能评估中的应用

李鑫磊¹, 魏伟², 宋健², 赵雨晴¹, 孔维橙¹, 蔡嘉玉¹, 施浩然¹, 薛偕华²^,³^,⁴()

1.福建中医药大学康复医学院，福建福州市 350003
2.福建中医药大学附属康复医院，福建福州市 350122
3.福建省认知功能康复重点实验室，福建福州市 350003
4.福建省康复技术重点实验室，福建福州市 350122

收稿日期:2024-11-21 修回日期:2025-02-28 出版日期:2025-04-25 发布日期:2025-04-25
通讯作者: 薛偕华(1978-)，男，汉族，主任医师，博士研究生导师，主要研究方向：帕金森病、认知障碍。E-mail: f110015@fjtcm.edu.cn
作者简介:李鑫磊(1996-)，男，汉族，山东淄博市人，硕士研究生，主要研究方向：神经康复。
基金资助:
1.福建省认知功能康复重点实验室开放项目(XKF2023007);2.福建中医药大学康复技术省部共建协同创新中心项目(X2022005);3.福建省卫生健康科研项目医学创新课题(2024CXA048)

Application of resting-state electroencephalography in assessment of upper limb motor function of stroke patients

LI Xinlei¹, WEI Wei², SONG Jian², ZHAO Yuqing¹, KONG Weicheng¹, CAI Jiayu¹, SHI Haoran¹, XUE Xiehua²^,³^,⁴()

1. College of Rehabilitation Medicine, Fujian University of Traditional Chinese Medicine, Fuzhou, Fujian 350003, China
2. Rehabilitation Hospital Affiliated to Fujian University of Traditional Chinese Medicine, Fuzhou, Fujian 350122, China
3. Key Laboratory for Cognitive Function Rehabilitation of Fujian Province, Fuzhou, Fujian 350003, China
4. Key Laboratory of Rehabilitation Technology of Fujian Province, Fuzhou, Fujian 350122, China

Received:2024-11-21 Revised:2025-02-28 Published:2025-04-25 Online:2025-04-25
Contact: XUE Xiehua, E-mail: f110015@fjtcm.edu.cn
Supported by:
Open Research Project of Fujian Key Laboratory of Cognitive Function Rehabilitation(XKF2023007);Rehabilitation Technology Innovation Center by Joint Collaboration of Ministry of Education and Fujian Province, Fujian University of Traditional Chinese Medicine(X2022005);Medical Innovation Project of Fujian Health Research Project(2024CXA048)

摘要/Abstract

摘要：

目的探讨存在上肢活动受限的脑卒中患者的静息态脑电图的电生理特征，并分析其评估脑卒中患者上肢运动功能的应用价值。
方法 2024年3月至8月，在福建中医药大学附属康复医院招募71例存在上肢活动受限的脑卒中患者作为卒中组，同时招募63例年龄、性别相匹配的健康人作为对照组。采用19导静息态脑电图采集受试者的脑电数据，计算同源电极对的脑对称性指数(pdBSI)和Delta/Alpha比值(DAR)。采用Fugl-Meyer运动评定量表上肢部分(FMA-UE)评估脑卒中患者的上肢运动功能，采用Brunnstrom分期评估脑卒中患者的上肢运动恢复水平，采用改良Barthel指数(MBI)评估脑卒中患者的日常生活活动能力。
结果相比对照组，卒中组在全局导联、额叶区域、中央区域和区域的Theta频段的pdBSI提高(|Z| > 3.016, P < 0.01)；全局导联、额叶区域和后部区域的pdBSI Beta2提高(|Z| > 3.222, P < 0.01)；全局导联、额叶区域、中央区域和后部区域的DAR均提高(|Z| > 6.565, P < 0.001)。卒中组全局导联(r = -0.280, P = 0.018)和中央区域(r = -0.304, P = 0.010)的pdBSI Delta与FMA-UE评分呈负相关；全局导联(r = -0.289, P = 0.014)、中央区域(r = -0.244, P = 0.040)和后部区域(r = -0.356, P = 0.002)的pdBSI Beta1与FMA-UE评分均呈负相关；全局导联(r = -0.431, P < 0.001)、额叶区域(r = -0.429, P < 0.001)、中央区域(r = -0.491, P < 0.001)和后部区域(r = -0.482, P < 0.001)的DAR均与FMA-UE评分呈负相关。
结论脑卒中患者存在Delta频段(0.5~4 Hz)和Beta频段(13~20 Hz)的半球间频谱功率不对称性，以中央区域较为明显，并与上肢活动受限相关。pdBSI Delta、pdBSI Beta1和DAR是评估脑卒中患者上肢运动功能的潜在神经电生理标志物。

关键词: 脑卒中, 脑电图, 上肢, 运动功能

Abstract:

Objective To investigate the features of resting-state electroencephalography (EEG) in stroke patients with limited upper limb movement, and assess its potential utility in evaluating upper limb motor function.
Methods From March to August, 2024, a total of 71 stroke patients with limited upper limb movement were enrolled as stroke group at the Rehabilitation Hospital Affiliated to Fujian University of Traditional Chinese Medicine; while 63 healthy participants matched for age and sex were recruited as control group. They were tested with 19-channel resting-state EEG (rsEEG), calculating of the pairwise derived brain symmetry index (pdBSI) and Delta/Alpha ratio (DAR). The motor function was assessed with Fugl-Meyer Assessment-Upper Extremities (FMA-UE), the upper limb recovery was evaluated with Brunnstrom Stages and the activities of daily living was assessed with modified Barthel index (MBI) in stroke patients,
Results Compared with the control group, the pdBSI of Global lead, Frontal region, Central region and Posterior region across Delta, Alpha and Beta1 frequency bands were significantly higher in the stroke group than in the control group (|Z| > 2.289, P < 0.05); as well as the pdBSI of Global lead, Central region and Posterior region across Theta bands (|Z| > 3.016, P < 0.01), the pdBSI of Global lead, Frontal region, Central region and Posterior region across Beta2 bands (|Z| > 3.222, P < 0.01), DAR of Global lead, Frontal region, Central region and Posterior region (|Z| > 6.565, P < 0.001). In the stroke group, the pdBSI of Global lead (r = -0.280, P = 0.018) and Central region (r = -0.304, P = 0.010) across the Delta band were significantly negatively correlated with FMA-UE, as well as the pdBSI of Global leads (r = -0.289, P = 0.014), Central region (r = -0.244, P = 0.040) and Posterior region (r = -0.356, P = 0.002) across the Beta1 band, and the DAR of Global lead (r = -0.431, P < 0.001), Frontal region (r = -0.429, P < 0.001), Central region (r = -0.491, P < 0.001) and Posterior region(r = -0.482, P < 0.001).
Conclusion Asymmetry in spectral power between hemispheres in the Delta (0.5 to 4 Hz) and Beta (13 to 20 Hz) bands is found in stroke patients, especially in the central region, which correlates with upper limb function limitations. pdBSI Delta, pdBSI Beta1 and DAR are potential neuroelectrophysiological markers for assessing upper limb motor function in stroke patients.

Key words: stroke, electroencephalogram, upper extremety, motor function

中图分类号:

R743

李鑫磊, 魏伟, 宋健, 赵雨晴, 孔维橙, 蔡嘉玉, 施浩然, 薛偕华. 静息态脑电图在脑卒中患者上肢运动功能评估中的应用[J]. 《中国康复理论与实践》, 2025, 31(4): 448-457.

LI Xinlei, WEI Wei, SONG Jian, ZHAO Yuqing, KONG Weicheng, CAI Jiayu, SHI Haoran, XUE Xiehua. Application of resting-state electroencephalography in assessment of upper limb motor function of stroke patients[J]. Chinese Journal of Rehabilitation Theory and Practice, 2025, 31(4): 448-457.

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参考文献 33

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组别	n	性别(男/女)/n	年龄/岁
对照组	63	41/22	64.00(55.00, 69.00)
卒中组	71	53/18	61.00(50.00, 70.00)
χ²/Z值		1.460	-0.446
P值		0.227	0.656

rsEEG指标	导联区域	对照组	卒中组	Z值	P值
pdBSI Delta	全局导联	0.04(0.00,0.10)	0.11(0.10,0.20)	-4.798	< 0.001
	额叶区域	0.06(0.00,0.10)	0.15(0.10,0.30)	-5.605	< 0.001
	中央区域	0.06(0.00,0.10)	0.12(0.10,0.30)	-4.270	< 0.001
	后部区域	0.06(0.00,0.10)	0.12(0.10,0.30)	-4.062	< 0.001
pdBSI Theta	全局导联	0.06(0.00,0.10)	0.09(0.00,0.20)	-3.112	0.002
	额叶区域	0.08(0.00,0.10)	0.10(0.00,0.20)	-1.047	0.295
	中央区域	0.06(0.00,0.10)	0.12(0.10,0.20)	-3.016	0.003
	后部区域	0.07(0.00,0.10)	0.12(0.10,0.20)	-3.221	0.001
pdBSI Alpha	全局导联	0.04(0.00,0.10)	0.080(0.00,0.20)	-4.032	< 0.001
	额叶区域	0.06(0.00,0.10)	0.07(0.00,0.20)	-2.289	0.022
	中央区域	0.05(0.00,0.10)	0.110(0.10,0.20)	-4.045	< 0.001
	后部区域	0.08(0.00,0.10)	0.12(0.10,0.20)	-2.294	0.022
pdBSI Beta1	全局导联	0.05(0.00,0.10)	0.09(0.10,0.20)	-4.270	< 0.001
	额叶区域	0.06(0.00,0.10)	0.11(0.10,0.20)	-3.549	< 0.001
	中央区域	0.09(0.00,0.20)	0.12(0.10,0.20)	-2.430	0.015
	后部区域	0.08(0.00,0.10)	0.12(0.10,0.20)	-3.359	0.001
pdBSI Beta2	全局导联	0.06(0.0,0.1)	0.130(0.1,0.2)	-3.957	< 0.001
	额叶区域	0.08(0.0,0.1)	0.150(0.1,0.2)	-3.222	0.001
	中央区域	0.15(0.1,0.2)	0.200(0.1,0.3)	-1.851	0.064
	后部区域	0.06(0.0,0.1)	0.140(0.1,0.2)	-3.387	0.001
DAR	全局导联	0.79(0.5,1.3)	2.76(1.30,4.80)	-7.012	< 0.001
	额叶区域	1.06(0.6,2.00)	3.72(1.70,7.00)	-6.825	< 0.001
	中央区域	0.86(0.60,1.30)	2.82(1.30,4.80)	-6.756	< 0.001
	后部区域	0.51(0.30,0.80)	1.82(0.80,3.60)	-6.565	< 0.001

rsEEG指标	AUC	SE	敏感性	特异性	95% CI	P值
pdBSI Delta(Global)	0.740	0.042	0.493	0.968	0.657~0.823	< 0.001
pdBSI Delta(Central)	0.714	0.045	0.606	0.794	0.626~0.801	< 0.001
pdBSI Beta1(Global)	0.714	0.044	0.704	0.651	0.627~0.800	< 0.001
pdBSI Beta1(Central)	0.622	0.048	0.451	0.730	0.527~0.716	0.015
pdBSI Beta1(Posterior)	0.668	0.047	0.620	0.667	0.577~0.759	0.001
DAR(Global)	0.852	0.033	0.662	1.000	0.787~0.917	< 0.001
DAR(Frontal)	0.842	0.034	0.662	0.952	0.776~0.909	< 0.001
DAR(Central)	0.839	0.035	0.690	0.921	0.770~0.907	< 0.001
DAR(Psterior)	0.829	0.037	0.676	0.921	0.758~0.901	< 0.001

静息态脑电图在脑卒中患者上肢运动功能评估中的应用

Application of resting-state electroencephalography in assessment of upper limb motor function of stroke patients

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