急性脑梗死偏瘫患者踝关节运动功能障碍的fMRI研究  

Hemiplegic Patients with Acute Cerebral Dysfunction Ankle fMRI Study

作　　者：高润[1] 任彦景[2] 钱竞光[3] 

机构地区：[1]南京脑科医院,江苏南京210029 [2]南京中医药大学,江苏南京210029 [3]南京体育学院,江苏南京210014

出　　处：《南京体育学院学报（自然科学版）》2010年第4期1-4,共4页Joournal of Nanjing Institute of Physical Education:Natural Science

基　　金：南京市医学科技发展项目重点课题;项目编号:ZKX06026

摘　　要：目的:利用功能磁共振成像(fMRI)技术,观察急性脑梗死患者的运动相关皮层的激活图,探讨卒中后踝功能障碍及恢复的脑功能相关性改变。方法:采用1.5T磁共振成像系统对10例急性脑梗死患者和5例正常志愿者进行BOLD-fMRI检查,采用健侧、患侧踝关节背伸、趾屈运动作为刺激任务,比较正常志愿者与急性脑梗死患者踝关节运动时脑部激活情况的异同,并采用LI为指标,观察急性脑梗死患者健侧、患侧踝关节运动时脑部激活的差异。结果:正常对照组踝关节运动主要激活对侧SM1区,激活区形态呈斑片状或者不规则状,此外对侧PM区、SMA区也有不同程度的激活。急性脑梗死患者健侧踝关节运动主要激活对侧SM1区,此外对侧PM区、SMA区、颞叶、枕叶、小脑半球、额叶等也有不同程度的激活,与正常对照组激活区相似;患侧踝关节运动(主观运动)时除了对侧半球SM1区激活之外,同侧SM1区、PM区也可见不同程度的激活,对侧半球的激活体积大部分大于同侧。根据公式计算出LI值,结果显示健侧、患侧踝关节运动LI值之间存在显著性差异(P<0.05)。结论:fMRI可以客观的显示急性脑梗死后患者大脑运动皮层的激活情况,提示存在脑功能代偿与重组,fMRI作为监测和研究急性脑梗死后运动功能恢复的有用工具,在临床治疗中具有重要的指导意义。Objective：to use functional magnetic resonance imaging（fMRI） technology,acute cerebral infarction were related to the movement of the cortex,sports functional activation graph characteristics and ankle joint function and the related parts of the brain,to guide clinical rehabilitation.Methods：1.5T MRI systems of 10 patients with acute cerebral infarction and 5 normal volunteers use BOLD-fMRI examination,the use of the contralateral,ipsilateral ankle dorsiflexion,toe flexion as the stimulus task,compared to normal volunteers ankle joint in patients with acute cerebral infarction during exercise the brain activation of the similarities and differences,and using LI as an indicator in patients with acute cerebral infarction contralateral,ipsilateral ankle movement differences.Results：In normal control group,the main activation of the contralateral ankle SM1 area,activated form of patchy areas or irregular shapes,in addition to the contralateral PM area,SMA area there are different degrees of activation.Acute cerebral infarction mainly activated contralateral ankle area contralateral SM1,in addition to the contralateral PM area,SMA area,temporal lobe,occipital lobe,cerebellum,frontal lobe,also have different levels of activation,with the normal control group,the similar activation;ipsilateral ankle area when the addition to the contralateral hemisphere SM1 activation,the ipsilateral SM1 area,PM can be seen are also different degrees of activation of the contralateral hemisphere ipsilateral activation volume is larger than most.LI values calculated according to the formula,the calculation results show that LI value on the side,between LI ankle movement significantly（P 0.05）.Conclusion：the physiological experiments using fMRI can objectively show patients after acute cerebral infarction of the motor cortex,the brain activated,indicating that the existence of brain function and physiological experiments using fMRI,compensatory as monitoring and research in acute cerebral infarction after sports functional

关 键 词：功能磁共振成像(fMRI) 急性脑梗死 踝关节 

分 类 号：G804.5[文化科学—运动人体科学]