脊髓损伤截瘫患者序列对指运动fMRI研究

发布时间：2018-02-08 08:20

本文关键词： 脊髓损伤功能磁共振成像运动皮质对指运动重组　出处：《放射学实践》2015年12期 　论文类型：期刊论文

【摘要】：目的:采用血氧水平依赖功能磁共振成像(BOLD-fMRI)观察脊髓损伤(SCI)截瘫患者序列对指运动时的脑激活模式,探讨SCI后脑运动功能代偿重组机制。方法:12例手部感觉运动功能正常的SCI截瘫患者(SCI组)和12例健康志愿者(对照组)行序列对指运动fMRI扫描,采用组块设计,30s静息和30s右手序列对指运动交替进行,重复4次,总扫描时间240s。使用SPM8软件分析右手序列对指运动时个体水平、组内及组间水平的脑激活模式,分析SCI组对侧大脑激活最强点T值、对侧初级运动皮质(M1)激活体积与损伤平面、损伤后时间及运动评分之间的相关性。结果:两组中对侧激活最强点T值及M1激活体积的差异无统计学意义(P0.05),SCI组对侧M1激活体积与损伤平面呈负相关(r=-0.807,P=0.009)。与对照组比较,SCI组对侧激活最强点向后移位,双侧M1、辅助运动区(SMA)、岛叶及顶下小叶激活增强。结论:脊髓损伤截瘫患者远隔部位运动相关脑区发生代偿重组,且与脊髓损伤平面相关。
[Abstract]:Objective: to observe the pattern of brain activation in patients with spinal cord injury (sci) paraplegia by using blood oxygen level dependent functional magnetic resonance imaging (BOLD-f MRI). To explore the compensatory mechanism of brain motor function after SCI. Methods 12 cases of SCI paraplegia with normal hand sensorimotor function and 12 healthy volunteers (control group) were scanned by fMRI. Two pairs of finger movements were performed alternately in 30 s rest and 30 s right hand sequences, repeated 4 times, and the total scanning time was 240 s. SPM8 software was used to analyze the brain activation patterns at individual level, intra-group and inter-group level in the right hand sequence. The activation volume and injury plane of contralateral cerebral activation point T and contralateral primary motor cortex M1 were analyzed in SCI group. Results: there was no significant difference between T value and M1 activation volume at the strongest point of contralateral activation in the two groups. There was a negative correlation between the activation volume of M1 and the injury plane in the contralateral M1 activation volume in the sci group, and the correlation between the activation volume of the contralateral M1 and the injury plane was negative correlation with that of the control group. The contralateral activation point of sci group was shifted backward. Bilateral M1, SMAA, insular lobes and inferior parietal lobules were enhanced. Conclusion: compensatory recombination occurs in the motor related brain areas of the distal region of spinal cord injury paraplegia, and is related to the spinal cord injury level.
【作者单位】：武汉大学中南医院MRI室;
【基金】：国家自然科学基金资助项目(81171315,81227902)
【分类号】：R445.2;R651.2

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