脑瘫患儿脑功能连接偏侧性研究

发布时间：2018-05-17 00:11

本文选题：脑瘫 + 静息态功能磁共振　；参考：《电子科技大学》2017年硕士论文

【摘要】：小儿脑性瘫痪(简称脑瘫)是我国目前最主要的肢体残疾性疾病,主要表现为中枢性运动功能障碍和姿势异常。脑瘫疾病的主要发病原因是因为出生前、出生时以及在出生一岁以内某些因素导致其先天性脑发育缺陷,继而造成中枢性运动障碍以及姿势异常,大多是因为损害了处在生长发育阶段未成熟的脑组织。脑瘫主要表现为肌肉由于失去了中枢神经的正常支配,变得僵硬或者松软,四肢无法完成正常的肢体活动;他们的肌肉组织都是正常的,病因在大脑,因此称为脑性瘫痪。两侧大脑半球在是不对称的,不论是结构上还是功能上都存在着诸多不同。大脑皮层在执行运动、感觉、语言等这些脑功能时是存在偏侧性的,偏侧性作为一种脑连接特性的一种指标,可以从侧面反应大脑协调合作的能力程度。本研究主要是关于脑瘫儿童大脑左右半球功能偏侧性的研究。本文基于静息态功能磁共振成像技术和脑偏侧性研究的分析方法,对脑瘫患儿的大脑偏侧性进行了研究。第一通过静息态脑网络进行网络偏侧性分析,具体是通过独立成分分析得到若干个脑网络,计算每个网络的局部偏侧性图谱,以及每个网络的偏侧辅因子。第二方法是通过同伦功能连接,即通过量化大脑某侧每个体素的静息态功能磁共振信号与大脑对侧镜像位置的每个体素的静息态功能磁共振信号之间的功能连接强度,以此来评估各个脑区的协调程度。本次研究主要是通过静息态功能磁共振成像,进行脑网络以及同伦体素之间的偏侧性研究,为认知神经科学和脑偏侧性研究提供思路。经过对脑瘫儿童以及正常儿童在局部偏侧性图谱以及全局偏侧辅因子的组间统计对比分析,在默认网络、小脑网络以及额顶网络等方面脑瘫儿童无论术前术后其功能连接强度低于正常儿童,但是在经过颈动脉内膜剥离术以及运动想象的康复治疗后,小脑网络的一部分、默认网络以及额顶网路在偏侧性方面,也就是功能连接方面有所升高,这说明手术以及康复治疗对脑瘫的恢复起到了一定的作用;经过同伦功能连接发现脑瘫儿童在中央后回、辅助运动区、小脑、壳核等区域功能连接降低,这表明脑瘫儿童的运动功能的集成性降低,为脑瘫儿童的运动异常提供了依据;在丘脑位置脑瘫儿童的同伦功能连接也出现降低,而丘脑具有中继功能,作为感觉的中继站,接收多方面的传入纤维,与大脑皮质的联络区有往返纤维联系,这为脑瘫儿童在感觉反应方面以及认知反馈方面普遍低于正常儿童提供了理论依据。
[Abstract]:Cerebral palsy in children (referred to as cerebral palsy) is one of the most important limb disability diseases in China, which is characterized by central motor dysfunction and abnormal posture. The main causes of cerebral palsy are congenital brain defects before birth, at birth and within one year of birth, resulting in central motor disorders and postural abnormalities. It is mostly because of damage to immature brain tissue at the stage of growth and development. The main manifestation of cerebral palsy is that the muscles become stiff or soft due to the loss of the central nervous system, and the limbs can not complete normal limb activities; their muscle tissue is normal, the cause of which is in the brain, so it is called cerebral palsy. Both hemispheres are asymmetrical, both structurally and functionally different. The cerebral cortex is characterized by laterality when performing motor, sensory and language functions. As an indicator of brain connection, laterality can reflect the ability of the brain to coordinate and cooperate from the side. This study is mainly about hemispheric hemispheres in children with cerebral palsy. Based on resting functional magnetic resonance imaging (fMRI) and the analysis of cerebral hemiplegia in children with cerebral palsy (CP), the hemipotency of the brain was studied. In the first place, the network laterality is analyzed by resting brain network. In particular, a number of brain networks are obtained by independent component analysis (ICA), and the local laterality maps of each network are calculated, as well as the sideline cofactors of each network. The second method is through homotopy functional connectivity, that is, by quantifying the functional magnetic resonance signal between the resting state of each voxel in one side of the brain and the resting functional magnetic resonance signal of each voxel in the contralateral mirror image of the brain. This was used to assess the degree of coordination among the various brain regions. The purpose of this study is to study the laterality of brain network and homotopy by resting functional magnetic resonance imaging (fMRI) to provide ideas for the study of cognitive neuroscience and hemiplegia. After the statistical comparison and analysis of the local hemiplegic map and the global sideline cofactor in children with cerebral palsy and normal children, the results were compared in the default network. Cerebellar network and frontal-top network in children with cerebral palsy were lower than those in normal children before and after operation, but after carotid endarterectomy and rehabilitation of motor imagination, part of the cerebellar network was found in children with cerebral palsy. The default network and the forehead top network have increased in the aspect of laterality, that is, functional connection, which shows that surgery and rehabilitation play a certain role in the recovery of cerebral palsy. After homotopy functional connection, children with cerebral palsy are found to be in the posterior central gyrus. The functional junctions of auxiliary motor areas, cerebellum and putamen were decreased, which indicated that the integration of motor function in children with cerebral palsy was decreased, which provided the basis for the abnormal movement of children with cerebral palsy. The homotopy functional junctions of children with cerebral palsy also decreased in the thalamus position, while the thalamus had the function of relay, as a sensory relay station, receiving afferent fibers from many aspects, and connecting with the focal area of cerebral cortex to and fro. This provides a theoretical basis for children with cerebral palsy in sensory response and cognitive feedback than normal children.
【学位授予单位】：电子科技大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R742.3

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