外部扰动条件下脑性瘫痪青少年平衡能力和大脑激活特征的研究

关键词：脑性瘫痪  平衡能力  功能性近红外光谱

Keywords:cerebral palsy  balance  functional near-infrared spectroscopy

摘要：

      摘要 目的：探讨脑性瘫痪（CP）青少年和正常发育（TD）青少年平衡能力和大脑皮层激活水平的差异。 方法：招募CP与TD青少年各8例。应用AMTI三维测力台采集足底压力中心（COP）数据，以评价扰动与非扰动条件站立平衡能力，同步应用fNIRS采集辅助运动区（SMA）、中央前回（PreCG）、中央后回（PoCG）和顶上小叶（SPL）的氧合血红蛋白（ΔHbO2）浓度，以评价大脑皮层激活水平。 结果：①平衡能力指标：扰动条件下CP组DeltaAP、RMS、RMSAP、SPAP均显著大于对照组。CP组扰动条件下DeltaAP、DeltaML、RMS、RMSAP、SPAP显著大于非扰动条件。②大脑皮层激活水平指标：扰动条件下CP组SMA的△HbO2显著大于对照组。CP组扰动条件下SMA、PreCG、PoCG的△HbO2显著大于非扰动。 结论：相比于TD青少年，CP青少年在外部扰动条件下前后方向的平衡能力较差，SMA激活水平较高。受到外部扰动时，CP青少年前后方向的平衡能力降低，SMA、PreCG和PoCG激活水平增高。

Abstract:

      Abstract Objective： To explore the differences in balance ability and brain activation level between the cerebral palsy （CP） adolescents and the typically developing （TD）adolescents. Method： Eight adolescents with CP or TD were recruited in this study. The center of pressure （COP） was measured using an AMTI three-dimensional force platform to assess the standing balance under perturbation or non-perturbation condition. Brain activation level was also measured using the fNIRS device to collect the oxygenated hemoglobin concentrations （ΔHbO2） in the supplementary motor area （SMA）， precental gyrus （PreCG）， postcentral gyrus （PoCG） and superior parietal lobule （SPL）. Result： ①Balance ability indicators： During the perturbation condition， DeltaAP， RMS， RMSAP， SPAP in the CP group were significantly greater than those in the control group. In the CP group， DeltaAP， DeltaML， RMS， RMSAP， SPAP during the perturbation condition were significantly greater than those during the non-perturbation condition. ②Brain activation level indicators： During the perturbation conditions， the ΔHbO2 of SMA in the CP group were significantly greater than those in the control group. In the CP group， the ΔHbO2 of SMA， PreCG， PoCG during the perturbation condition were significantly greater than those during the non-perturbation condition. Conclusion： Compared to the TD adolescents， the CP adolescents had poorer balance in the anterior-posterior direction and higher level of SMA activation in the external perturbation condition. Under the external perturbation condition， the balance ability decreased in the anterior-posterior direction， while the activation level of SMA， PreCG and PoCG increased in the adolescents with CP.