基于功能性近红外光谱成像的卒中后焦虑患者前额叶皮质激活特征及机制研究

doi:10.3969/j.issn.1006-9771.2026.03.009

《中国康复理论与实践》 ›› 2026, Vol. 32 ›› Issue (3): 329-336.doi: 10.3969/j.issn.1006-9771.2026.03.009

基于功能性近红外光谱成像的卒中后焦虑患者前额叶皮质激活特征及机制研究

杨玲¹, 王庆雷², 王洁¹, 徐雯婕¹, 王彤², 郭川²(), 钱雪¹()

¹ 常州市德安医院，江苏常州市 213004
² 南京医科大学第一附属医院，江苏南京市 210029

收稿日期:2025-11-06 修回日期:2026-01-28 出版日期:2026-03-25 发布日期:2026-04-01
通讯作者: 钱雪(1983-)，女，汉族，江苏镇江市人，副主任护师，主要研究方向：康复护理及康复管理，E-mail：qianxuenurse@126.com；郭川(1988-)，男，汉族，江苏连云港市人，博士，副主任技师，硕士研究生导师，主要研究方向：神经系统疾病康复治疗，E-mail：guochuan@njmu.edu.cn。
作者简介:杨玲(1988-)，女，汉族，江苏常州市人，主管护师，主要研究方向：康复护理及心理护理
基金资助:
1.国家重点研发计划项目(2023YFC3603604);2.国家自然科学基金青年项目(82302882)

Activation patterns and mechanism in the prefrontal cortex of post-stroke anxiety patients: a study using functional near-infrared spectroscopy

YANG Ling¹, WANG Qinglei², WANG Jie¹, XU Wenjie¹, WANG Tong², GUO Chuan²(), QIAN Xue¹()

¹ Changzhou De'an Hospital, Changzhou, Jiangsu 213004, China
² The First Affiliated Hospital of Nanjing Medical University, Nanjing, Jiangsu 210029, China

Received:2025-11-06 Revised:2026-01-28 Published:2026-03-25 Online:2026-04-01
Contact: QIAN Xue, E-mail: qianxuenurse@126.com; GUO Chuan, E-mail: guochuan@njmu.edu.cn
Supported by:
National Key Research and Development Program of China(2023YFC3603604);National Natural Science Foundation of China (Youth)(82302882)

摘要/Abstract

摘要：

目的运用功能性近红外光谱成像技术，观察卒中后焦虑(PSA)患者前额叶皮质的激活及功能连接特征，探讨其潜在神经机制。

方法 2024年12月至2025年9月，于常州市德安医院招募脑卒中患者120例，根据汉密尔顿焦虑量表(HAMA)将患者分为PSA组(n = 60)和非PSA组(n = 60)。所有患者均佩戴18通道fNIRS采集帽进行检测，观察两组额极区与背外侧前额叶区(DLPFC)在静息态下的功能连接差异，以及任务态下相应脑区激活情况。

结果静息态功能连接分析显示，两组在额极区和DLPFC间的网络连接均无显著性差异(|t| < 1.301, P > 0.05)。任务态激活结果显示，与非PSA组相比，PSA组健侧额极区激活降低(Z = -2.063, P < 0.05)，且该区域激活水平与HAMA评分呈负相关(ρ = -0.201, P = 0.028)。

结论 PSA患者在任务态下健侧额极激活水平降低，且激活水平与焦虑程度呈负相关。

关键词: 脑卒中, 卒中后焦虑, 功能性近红外光谱, 功能连接, 皮质激活

Abstract:

Objective To observe the activation patterns and functional connectivity in the prefrontal cortex of patients with post-stroke anxiety (PSA) using functional near-infrared spectroscopy, in order to explore the underlying neural mechanism.

Methods From December, 2024 to September, 2025, 120 stroke patients were selected in Changzhou De'an Hospital. They were divided into PSA group (n = 60) and non-PSA group (n = 60) according to the score of Hamilton Anxiety Scale (HAMA). All patients wore an 18-channel fNIRS acquisition cap for detection. The differences in resting-state functional connectivity between the frontopolar cortex (FPC) and dorsolateral prefrontal cortex (DLPFC) were examined in both groups, as well as task-related activation in these brain regions.

Results Resting-state functional connectivity analysis revealed no statistically significant difference in network connectivity between two groups in the FPC and DLPFC regions (|t| < 1.301, P > 0.05). Task-related activation results revealed significantly reduced activation in the contralateral FPC of PSA group compared to the non-PSA group (Z = -2.063, P < 0.05). Activation levels in this region showed a negative correlation with the scores of HAMA (ρ = -0.201, P = 0.028).

Conclusion Activation decreased in the contralateral frontal pole during the task state for patients with PSA, and the activation levels negatively correlates with anxiety severities.

Key words: stroke, post-stroke anxiety, functional near-infrared spectroscopy, functional connectivity, cortical activation

中图分类号:

R743.3

杨玲, 王庆雷, 王洁, 徐雯婕, 王彤, 郭川, 钱雪. 基于功能性近红外光谱成像的卒中后焦虑患者前额叶皮质激活特征及机制研究[J]. 《中国康复理论与实践》, 2026, 32(3): 329-336.

YANG Ling, WANG Qinglei, WANG Jie, XU Wenjie, WANG Tong, GUO Chuan, QIAN Xue. Activation patterns and mechanism in the prefrontal cortex of post-stroke anxiety patients: a study using functional near-infrared spectroscopy[J]. Chinese Journal of Rehabilitation Theory and Practice, 2026, 32(3): 329-336.

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组别	PSA组(n = 60)	非PSA组(n = 60)	t/χ²/Z值	P值
年龄/岁	62.20±11.81	62.27±12.35	-0.030	0.976
性别/n	43/17	44/16	0.042	0.838
卒中类型(缺血性/出血性)/n	50/10	42/18	2.981	0.084
卒中侧(左/右)/n	26/34	31/29	0.835	0.361
MoCA评分	20.00(16.00, 24.00)	22.50(18.00, 25.00)	-1.607	0.108
HAMA评分	12.00(8.00, 15.75)	2.00(0.00, 3.00)	-9.458	< 0.001

ROI-ROI	PSA组(n = 60)	非PSA组(n = 60)	t值	P值
患侧额极-患侧DLPFC	1.159±0.547	1.129±0.535	0.300	0.764
患侧额极-健侧DLPFC	0.893±0.488	0.960±0.461	-0.769	0.443
患侧额极-健侧额极	1.205±0.446	1.192±0.430	0.160	0.873
患侧DLPFC-健侧DLPFC	1.091±0.572	1.211±0.432	-1.301	0.196
患侧DLPFC-健侧额极	0.904±0.519	0.960±0.473	-0.613	0.541
健侧DLPFC-健侧额极	1.162±0.525	1.204±0.578	-0.415	0.679

ROI	PSA组(n = 60)	非PSA组(n = 60)	Z值	P值
患侧额极	0.077(-0.029, 0.140)	0.106(0.005, 0.275)	-1.375	0.169
患侧DLPFC	0.044(-0.036, 0.142)	0.100(-0.014, 0.210)	-1.533	0.125
健侧DLPFC	0.027(-0.031, 0.094)	0.081(-0.034, 0.211)	-1.470	0.142
健侧额极	0.084(-0.027, 0.140)	0.100(-0.006, 0.251)	-2.063	0.039

ROI	ρ	P
患侧额极	-0.124	0.178
患侧DLPFC	-0.138	0.132
健侧DLPFC	-0.129	0.159
健侧额极	-0.201	0.028

基于功能性近红外光谱成像的卒中后焦虑患者前额叶皮质激活特征及机制研究

Activation patterns and mechanism in the prefrontal cortex of post-stroke anxiety patients: a study using functional near-infrared spectroscopy

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