基于功能性近红外光谱技术的脑卒中患者运动脑区激活及功能连接研究

关键词：脑卒中  功能性近红外光谱技术  氧合血红蛋白  功能连接

Keywords:stroke  functional near-infrared spectroscopy  oxyhemoglobin  functional connectivity

摘要：

      摘要 目的：利用功能性近红外光谱（functional near-infrared spectroscopy， fNIRS）分析健康人与脑卒中上肢运动功能障碍患者运动脑区激活及功能连接特征。 方法：选择30例脑卒中右侧上肢运动功能障碍患者作为观察组，年龄和性别相匹配的30例健康人作为对照组。利用fNIRS分析受试者静息状态（resting state， RS），以及右肘被动运动（passive motion， MP）和运动想象（motor imagery， MI）状态下初级体感皮层（primary somatosensory cortex， PSC）、初级运动皮层（primary motor cortex， PMC）、前运动区和辅助运动皮层（supplementary motor cortex， SMC）、前额叶皮层（prefrontal cortex， PFC）、背外侧前额叶皮层（dorsolateral prefrontal cortex， DLPFC）等运动脑区的氧合血红蛋白（oxyhemoglobin， HbO2）浓度和功能连接（functional connectivity， FC）强度。 结果：受试者的一般人口学和临床特征资料显示，观察组和对照组在性别、年龄、受教育程度，以及体质量指数没有显著性差异（P>0.05）；观察组MMSE评分显著低于对照组，差异存在显著性意义（P<0.05）。观察组和对照组RS状态下运动脑区HbO2浓度没有显著性差异（P>0.05），但观察组的FC强度显著低于对照组（P<0.05）；观察组MI状态下同侧（右侧）PMC、SMC、DLPFC及双侧PFC的HbO2浓度均显著低于对照组（P<0.05）；观察组MP状态下对侧（左侧）PMC的HbO2浓度显著低于对照组（P<0.05）。 结论：fNIRS可应用于运动相关的脑功能研究。脑卒中运动功能障碍患者运动相关脑区的激活和功能连接特征可成为康复疗效评估的潜在标志物。

Abstract:

      Abstract Objective： To analyze brain activation and functional connectivity （FC） of motor brain regions in healthy individuals and stroke patients with right upper limb dysfunction after stroke by functional near-infrared spectroscopy （fNIRS）. Method： Thirty stroke patients with right upper limb dysfunction after stroke who met the inclusion and exclusion criteria were enrolled as the observation group， and 30 healthy older individuals with matching age and gender were selected as the control group. The fNIRS analysis was used to study the oxyhemoglobin （HbO2） concentration and functional connectivity （FC） strength in motor brain regions including the primary somatosensory cortex （PSC）， primary motor cortex （PMC）， supplementary motor cortex （SMC）， prefrontal cortex （PFC）， and dorsolateral prefrontal cortex （DLPFC） during the resting state， motor passivity （MP） and motor imagery （MI） of the right elbow. Result： There was no statistical difference in gender， age， education level and body mass index （BMI） between the observation group and the control group （P>0.05）. The MMSE scores of the observation group were significantly lower than the control group， and the difference was statistically significant （P<0.05）. In resting state （RS）， the HbO2 concentration in the motor brain region was no significant difference in the observation group and the control group （P>0.05）， but the FC strength in the observation group was significantly lower than the control group （P<0.05）； In MI， the HbO2 concentrations in the ipsilateral （right） PMC， SMC， DLPFC and bilateral PFC was significantly lower in the observation group than the control group （P<0.05）； In MP， the HbO2 concentrations in the contralateral （left） PMC was significantly lower in the observation group than the control group （P<0.05）. Conclusion： fNIRS can effectively assess brain function related to movement. The activation and functional connectivity characteristics of brain regions related to movement in patients with motor dysfunction after stroke can be potential markers for the evaluation of rehabilitation outcomes.