fMRI动态观察脑梗死患者脑运动功能的恢复

发布时间：2018-06-27 00:53

本文选题：大脑梗死 + 磁共振成像　；参考：《中国医学影像技术》2015年05期

【摘要】：目的采用fMRI纵向观察脑梗死患者双手握拳运动时脑功能区的动态重组和代偿情况,并探讨其与运动功能恢复水平的关系。方法 34例脑梗死患者(病例组)及16名正常人(正常对照组)分别进行双手的握拳运动,进行实时BOLD-fMRI,病例组在发病1周内(早期)首次扫描,其中11例患者5~7周(恢复期)再次接受扫描,正常对照组只扫描1次。应用SPM8软件测定初级运动皮层(M1)激活体积,计算偏侧化指数(LI)及Fugl-Meyer Assessment(FMA)运动积分,分析LI与FMA积分在早期和恢复期的变化。结果早期患手运动激活双侧M1、次级运动皮层,恢复期主要激活对侧M1、次级运动皮层,同侧脑激活区减少;脑梗死患者LI与FMA值在早期与恢复期差异均有统计学意义(P均0.05)。患者健侧肢体运动的脑激活模式与正常人相似。结论 BOLD-fMRI可显示梗死患者脑皮层运动代表区的动态重塑过程,可为脑梗死治疗康复提供重要基础和方法。
[Abstract]:Objective to observe the dynamic recombination and compensation of cerebral functional area in patients with cerebral infarction by fMRI, and to explore the relationship between fMRI and the recovery level of motor function. Methods 34 patients with cerebral infarction (case group) and 16 normal subjects (normal control group) were given hand grip exercise and real time BOLD-fMRI.The case group was scanned for the first time within 1 week (early stage). Among them, 11 patients were re-scanned at 7 weeks (convalescence), but only once in the normal control group. The activation volume of primary motor cortex (M1) was measured by SPM8 software. The partial lateralization index (Li) and Fugl-Meyer Assessment (FMA) were calculated, and the changes of Li and FMA in early stage and recovery stage were analyzed. Results the activation of bilateral M1, secondary motor cortex, contralateral M1, secondary motor cortex and ipsilateral activated area decreased in early stage, and the difference of Li and FMA between early stage and convalescence stage was statistically significant (P 0.05). The brain activation pattern of healthy limb movement in patients was similar to that in normal subjects. Conclusion BOLD-fMRI can show the dynamic remodeling process of cerebral cortex motor representative area in patients with cerebral infarction, and can provide an important basis and method for the rehabilitation of cerebral infarction.
【作者单位】：安徽医科大学第一附属医院放射科;
【基金】：国家自然科学基金(81171326) 安徽省科技厅科技攻关项目(1301042202)
【分类号】：R743.33;R445.2

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