皮质下梗死运动功能康复的纵向BOLD-fMRI研究  

Longitudinal fMRI Study of Motor Recovery After Sub-cortical Stroke

作　　者：张瑞[1,2] 陈增爱[1] 沈加林[1] 许建荣[1] 徐群[3] 王颖[4] 

机构地区：[1]上海交通大学医学院附属仁济医院放射科 [2]浙江大学医学院附属第一医院放射科 [3]上海交通大学医学院附属仁济医院神经内科 [4]上海交通大学医学院附属仁济医院康复科

出　　处：《中国医学计算机成像杂志》2010年第6期466-470,共5页Chinese Computed Medical Imaging

基　　金：上海市科学技术委员会国际科技合作基金项目(07SP07006);上海交通大学医学院重点学科项目;上海市重点学科建设项目(S30203)~~

摘　　要：目的:应用BOLD-fMRI纵向研究皮质下梗死患者大脑运动激活区的动态变化,探索大脑运动功能重组的规律及与康复水平的关系。方法:对10例皮质下梗死的脑卒中偏瘫患者分别于发病1周内、1个月和3个月后进行BOLD-fMRI扫描;上肢运动功能采用Fugl-Meyer评分法评分。7例年龄相仿的健康试者作为对照组。采用SPM5软件后处理,计算双侧初级感觉运动区(SM1)激活体积,并计算偏侧化指数(LI)。结果:患肢运动时同(健)侧SM1区激活体积于发病1周内、1个月时明显大于对照组,3个月后随着运动水平恢复而与对照组相仿。LI值发病1周内、1个月时小于对照组,3个月时与对照组相仿。患肢运动时LI值与患者运动功能评分之间无明显相关性(P>0.05)。结论:皮质下梗死后不仅激活对侧运动传导通路,同侧运动传导通路也有不同程度的激活。随着运动功能的逐渐恢复,由双侧SM1区的广泛激活逐渐趋向于以对侧SM1区激活为主。Purpose：To explore the dynamic changes of motor-related cortical activation of the sub-cortical stroke patients with BOLD-fMRI,and to evaluate the relationship between brain reorganization and motor recovery.Methods：Ten patients with sub-cortical infarct were undergone the fMRI scanning three times,at one week,one months and 3 months after onset respectively,and their motor rehabilitation was assessed with Fugl-Meyer score.Seven volunteers were recruited.All the data was analyzed by using SPM5 software,the activated volume of the primary sensorimotor cortex（SM1） and Laterality index（LI）were calculated.Result：The activation volume of ipsilateral SM1 was significantly larger than that of controls at the acute phase and one months after onset.Three months later,with the motor recovery,it was the same as controls.LI of the SM1 was higher than controls at one week and one months after onset.There was no significant statistical difference in the LI and the F-M scores（P0.05）.Conclusion： After subcortical stroke,there are not only the activations of the contralateral motor conduction pathway,but also the different degrees of activations of the ipsilateral motor conduction pathway.With the improvement of the motor function,it was gradually changed to the mainly contralateral activation.

关 键 词：卒中 功能磁共振 运动功能 康复 

分 类 号：R445.2[医药卫生—影像医学与核医学] R743.3[医药卫生—诊断学]