论文部分内容阅读
目的:本研究利用功能性磁共振成像(fMRI)技术观察急性期缺血性脑卒中病人的运动相关皮层的激活图,探讨卒中后脑功能重组特点及其与运动恢复的关系。方法:采用GE1.5T双梯度16通道磁共振成像系统,对9例急性期缺血性脑卒中患者和9例志愿者进行Bold-fMRI检查。fMRI应用被动对指运动作为任务刺激,所有数据进行离线后处理,应用SPM2软件处理fMRI图像,观察运动相关皮层激活情况。比较正常被试与卒中病人之间fMRI结果的异同,测量脑激活区体积以及信号强度,计算单侧化指数(LI),考察卒中病人患手运动时LI与肌力的关系。结果:正常被试对指运动激活对侧感觉运动皮层(SMC)、双侧辅助运动区(SMA)。卒中病人患手运动时健侧半球激活增多,健手运动时fMRI结果基本同正常被试。LI也进一步确定,卒中病人患手运动时健侧激活增多。相关分析表明,卒中病人患手运动时LI与肌力呈正相关趋势。结论:本研究表明fMRI能客观地显示脑卒中后患者运动皮层激活与正常被试不同,提示存在脑功能代偿与重组。本研究探讨了病人患侧和健侧半球激活体积与肌力的关系,提示fMRI是研究脑卒中后运动康复与脑功能重组之间关系的一种有效工具。
OBJECTIVE: In this study, we used functional magnetic resonance imaging (fMRI) to observe the motor-related cortical activation in patients with acute ischemic stroke and to explore the relationship between brain functional remodeling and motor recovery after stroke. METHODS: Bold-fMRI was performed on nine patients with acute ischemic stroke and nine volunteers using the GE 1.5T dual gradient 16-channel MR system. fMRI application of passive motion refers to the movement as a task stimulus, all data off-line post-processing, the application of SPM2 software fMRI images to observe the movement-related cortical activation. The similarities and differences between fMRI results of normal subjects and stroke patients were compared. The volume of brain activation area and signal intensity were measured, and the unilateral index (LI) was calculated. The relationship between LI and muscle strength in stroke patients was investigated. Results: The normal subjects were referring to motor activation of contralateral sensory motor cortex (SMC) and bilateral motor area (SMA). Patients with stroke had increased hemispheric activation in the contralateral hemisphere during hand movements, and fMRI results were basically normal in stroke hand exercises. LI also further confirmed that stroke patients suffering from contralateral hand movement increased. Correlation analysis showed that there was a positive correlation between LI and muscle strength in stroke patients with hand movement. CONCLUSIONS: This study shows that fMRI objectively shows that motor cortex activation differs from normal subjects in stroke patients, suggesting the existence of brain function compensation and reorganization. This study explored the relationship between the patient’s ipsilateral and contralateral hemispheric activation volume and muscle strength, suggesting that fMRI is an effective tool for studying the relationship between motor rehabilitation and functional brain reorganization after stroke.