多通道功能性电刺激结合任务导向训练对脑卒中上肢偏瘫患者脑功能网络的即刻影响
Immediate effect of multi-chancel functional electrical stimulation combined with task-oriented training on brain functional network in stroke patients with upper limb hemiplegia
陈园月 1李加斌 2蒯凤 2彭丽丽 2项洁3
作者信息
- 1. 徐州医科大学第二临床医学院,江苏徐州市 221000;盐城德馨医院,江苏盐城市 224000
- 2. 盐城市第一人民医院,江苏盐城市 224000
- 3. 徐州医科大学附属医院,江苏徐州市 221000
- 折叠
摘要
目的 应用功能性近红外光谱(fNIRS)观察脑卒中上肢偏瘫患者在多通道功能性电刺激(FES)结合任务导向训练诱导下的脑功能网络变化.方法 选取2023年4月至10月在盐城市第一人民医院住院治疗的脑卒中偏瘫患者15例,通过掷币决定阳性刺激和阴性刺激的顺序.阳性刺激在多通道FES下行任务导向训练,阴性刺激在伪刺激下行任务导向训练,间隔1 d.每次训练时,采用fNIRS测量患者双侧前额叶皮质(PFC)、前运动皮质(PMC)、辅助运动区(SMA)、感觉运动皮质(SMC)的氧合血红蛋白的浓度,计算总体功能连接强度和感兴趣区的功能连接强度差异.结果 与阴性刺激相比,阳性刺激下,大脑皮质总体功能连接强度降低(t =-2.735,P<0.05),损伤对侧PFC-损伤同侧PFC和损伤对侧PFC-损伤对侧PMC的功能连接降低(P<0.05).结论 多通道FES结合任务导向训练可以优化脑卒中上肢偏瘫患者的皮质功能连接.
Abstract
Objective To observe the change of brain functional network of stroke patients with upper limb hemiplegia during task-oriented training under multi-channel functional electrical stimulation(FES)using functional near-infrared spec-troscopy(fNIRS).Methods From April to October,2023,15 stroke inpatients with upper limb hemiplegia were selected from the First Peo-ple's Hospital of Yancheng.They accepted task-oriented training,under real stimulation and sham stimulation de-termined with tossing a coin,with an interval of a day.The real stimulation was induced with multi-channel FES,and sham stimulation was induced with no stimulation.During the training,fNIRS was used to measure the con-centrations of oxygenated hemoglobin in the bilateral prefrontal cortex(PFC),premotor cortex(PMC),supple-mentary motor area(SMA)and sensorimotor cortex(SMC),to obtain the overall functional connectivity and the difference of functional connectivity based on region of interest.Results Compared with the sham stimulation,the overall functional connectivity reduced(t =-2.735,P<0.05);the functional connectivity between the contralesional PFC to ipsilateral PFC,and the contralesional PFC to contrale-sional PMC also reduced(P<0.05)under real stimulation.Conclusion Multi-channel FES combined with task-oriented training can optimize the cortical functional connectivity in stroke patients with upper limb hemiplegia.
关键词
脑卒中/多通道功能性电刺激/任务导向训练/功能性近红外光谱/脑功能网络Key words
stroke/multi-channel functional electrical stimulation/task-oriented training/functional near-infrared spectroscopy/brain functional network引用本文复制引用
基金项目
国家重点研发计划(2020YFC2006604)
出版年
2024
国家科技期刊平台
NSTL
万方数据