脑卒中患者强制性使用运动治疗的fMRI研究  

A fMRI Study of Cortical Reorganization in Chronic Stroke Hemiplegia Treated with Constraint-induced Movement Therapy

作　　者：温博[1] 马林[1] 瓮长水[2] 郑志新[3] 孙彤[3] 

机构地区：[1]解放军总医院放射诊断科,北京市100853 [2]解放军总医院南楼康复医学科,北京市100853 [3]解放军总医院康复医学科,北京市100853

出　　处：《中国康复理论与实践》2008年第4期366-367,共2页Chinese Journal of Rehabilitation Theory and Practice

基　　金：全军医药卫生科研基金资助项目(No.200626Z000058)

摘　　要：目的研究脑卒中偏瘫患者进行强制性使用运动疗法(CIMT)治疗前后fMRI的脑功能区激活变化。方法对5例后遗症期脑卒中患者进行上肢动作研究量表评价;fMRI试验采用组块设计,使用3.0T磁共振仪进行fMRI数据采集,在CIMT治疗前后对患者进行fMRI扫描。结果CIMT治疗后,患者患侧上肢运动功能显著改善(P<0.001),fMRI检查显示患侧运动区手部支配区域激活范围明显局限化,激活强度增加,临近激活区域明显减少,对侧代偿激活区域范围缩小。结论CIMT可以有效改善脑卒中患者上肢运动功能,诱发大脑皮质功能重塑是其机制的重要组成部分。Objective To investigate the evidence of cortical reorganization in stroke hemiplegia treated with constraint-induced movement therapy （CIMT） by fMRI. Methods Five patients with chronic stroke were evaluated with the Action Research Arm Test （ARAT）. The functional MRI （fMRI） was performed on a 3.0-T MRI with echo-planar imaging. The subjects were required to finish the finger-tapping task and undergo fMRI before and after CIMT. A block design was used for the inspection. Results After CIMT, the function of upper limb （sick side） of patients improved significantly assessed by ARAT （P〈0. 001）, and cortical reorganization was found on fMRI. Conclusion CIMT can improve motor function of upper limb of chronic stroke patients with hemiplegia and induce cortical reorganization as measured by fMRI.

关 键 词：脑卒中 强制性使用运动疗法 功能重组 

分 类 号：R743.3[医药卫生—神经病学与精神病学]