《中国康复理论与实践》

《中国康复理论与实践》 ›› 2010, Vol. 16 ›› Issue (7): 642-645.

• 论文 • 上一篇    下一篇

单侧皮层下缺血性脑卒中患者运动功能磁共振成像的纵向研究

郑作锋1，艾林1，戴建平1，张慧2   

  1. 1.首都医科大学附属北京天坛医院神经影像中心，北京市神经外科研究所神经影像中心，北京市 100050；2.中国科学院复杂系统与智能科学实验室，北京市 100080。
  • 收稿日期:2010-04-08 修回日期:1900-01-01 出版日期:2010-07-25 发布日期:2010-07-25
  • 通讯作者: 艾林

Functional Magnetic Resonance Imaging Finding of Motor Function Recovery after Unilateral Subcortical Ischemic Stroke: A Longitudinal Study

ZHENG Zuo-feng, AI Lin, DAI   

  1. Imaging Center of Neuroscience, Beijing Tiantan Hospital, Capital Medical University, Beijing 100050, China
  • Received:2010-04-08 Revised:1900-01-01 Published:2010-07-25 Online:2010-07-25

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被引次数

12

摘要： 目的分析单侧皮层下缺血性脑卒中患者患侧肢体运动时脑部激活区随时间的动态变化过程，以及与运动功能康复水平的关系。方法对6名健康志愿者与3例单侧皮层下缺血性脑卒中患者进行血氧水平依赖功能磁共振成像（BOLD-fMRI），分别采取单侧手指和患侧手指顺序对指运动任务。采用统计参数图进行数据分析和脑功能区定位，计算不同感兴趣区内激活体素数目，并计算偏侧化指数（LI）。扫描结束后记录患者上肢Fugl-Meyer运动评分。对患者在发病后8个月内分别行两侧BOLD-fMRI检查，比较两次激活区域及LI的变化。结果脑卒中患者激活区较健康人广泛，3例患者在发病早期激活范围存在差异，但均表现为双侧感觉运动区（SMC）激活；在发病晚期，肢体同侧SMC激活减少，对侧SMC激活增多，相应的半球、SMC、M1区LI增高。结论单侧皮层下脑梗死患者随着病程时间延长，功能区逐渐向对侧SMC局限化。

关键词: 脑卒中, 功能磁共振成像, 运动功能

Abstract: ObjectiveTo observe the course of motor related activation cortex after unilateral subcortical ischemic stroke. Methods6 healthy volunteers and 3 patients with solitary lacunar infarction in subcortical region underwent blood-oxygen level dependent functional MRI （BOLD-fMRI） as a block design of sequential finger tapping task. The data were analyzed with Statistical Parametric Mapping (SPM2). The activated voxels and the laterality index (LI) were calculated. The patients were assessed with the Fugl-Meyer Assessment of upper limb after scanning, and were scanned again 8 months after stroke. ResultsThe activated cortices in patients were more extensive than that of volunteers. In the early stage of stroke, the activation cortex involved the bilateral sensory motor cortex (SMC) in all the patients, but various in other regions. In the late stage, the ipsilateral activations decreased while the contralateral activation increased in SMC. The LI of hemisphere, SMC, and M1 is higher than the early stage. ConclusionThe motor related activation gradually localized to the contralateral SMC with motor function recovery.

Key words: stroke, functional magnetic resonance imaging, motor function