目的:基于静息态功能磁共振成像(functional magnetic resonance imaging,fMRI)研究慢性期左侧皮层下脑卒中后轻中度手功能障碍(部分偏瘫手)患者运动功能网络的重组模式.方法:招募32例脑卒中后部分偏瘫手患者和40例匹配的健康老年对照.采集两组受试者的静息态fMRI数据,并采用Fugl-Meyer腕手运动功能量表评定患者的手功能障碍程度.采用RESTplus软件分析双侧初级运动皮层(prima-ry motor cortex,M1)与全脑功能连接(functional connectivity,FC)的组间差异,并采用Pearson相关分析探究患者的FC模式与手功能评分之间的关系.结果:与健康老年对照相比,部分偏瘫手患者的患侧M1区与健侧感觉运动区、患侧海马和患侧颞中回的FC减弱,并且健侧M1区与患侧中央后回、健侧顶下小叶、患侧颞上回和患侧脑岛的FC也减弱.相关性分析发现,部分偏瘫手患者的健侧M1区与辅助运动区的FC强度与手功能评分正相关(r=0.67,P＜0.001).结论:慢性期左侧皮层下脑卒中后部分偏瘫手患者的运动功能网络发生了广泛的失连接重组,其中,健侧M1区与辅助运动区之间增强的FC可能是提示良好手功能结局的神经影像标记物.
Disruption of large-scale neurocircuitry in chronic stroke patients with partially paretic hand:A resting-state fMRI study
Objective:To study the lesion-induced functional reorganization pattems of the motor networks in patients with mild to moderate hand dysfunction(partially paretic hand)after chronic left subcortical stroke patients based on resting-state functional magnetic resonance imaging(rs-fMRI)data.Method:Thirty-two chronic stroke patients with partially paretic hand and forty matched healthy elderly con-trols were enrolled.Both groups were scanned by the resting-state fMRI and hand dysfunction was assessed by the Fugl-Meyer scale of hand and wrist.The RESTplus software was employed to analyze the group differenc-es of functional connectivity(FC)pattems between the bilateral primary motor cortex(Ml)and the whole brain.Meanwhile,Pearson correlation coefficient analysis was used to explore the relationships between FC pat-tems and hand function scores in all patients.Result:Compared with healthy controls,the FC between the ipsilesional M1 and the contralesional sensorimo-tor cortex,ipsilesional hippocampus and ipsilesional middle temporal gyrus was decreased in the stroke patients group,and the FC between the contralesional M1 and the ipsilesional postcentral gyrus,contralesional inferior parietal lobe,ipsilesional superior temporal gyrus and ipsilesional insular was also decreased.Furthermore,the FC strength between contralesional M1 and supplementary motor area was positively correlated with paretic hand performance(r=0.67,P＜0.001).Conclusion:The motor function network of patients with partial hemiplegia after left subcortical stroke in the chron-ic phase has undergone extensive disconnected reorganization,and the enhanced FC between the M1 area on the healthy side and the auxiliary motor area may be a neuroimaging marker indicating good hand function outcomes.
strokehand dysfunctionbrain plasticityresting-state functional magnetic resonance imagingfunctional connectivity
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NSTL
万方数据
