功能磁共振对脑卒中患者拇指运动时大脑活动的初步研究  

A pilot study of functional MRI to access the evidence for cerebral activation during thumb movement after stroke in humans

作　　者：张通[1] 钮竹[1] 方定华[1] 蒋涛[2] 金真[3] 

机构地区：[1]中国康复研究中心神经康复科,北京100077 [2]北京朝阳医院放射科 [3]中国人民解放军第三○六医院放射科

出　　处：《中华神经科杂志》2001年第4期234-236,共3页Chinese Journal of Neurology

基　　金：国家科技部"九五"科技攻关资助课题 ( 96 90 6 0 2 2 3)

摘　　要：目的　观察偏瘫患者拇指在不同运动形式下 ,大脑半球相关区域血氧水平的变化情况。方法　让患者分别进行健侧和患侧拇指被动运动、主动运动和加阻力下的主动运动。在患者运动时行功能磁共振 (F MRI)检查 ,观察上述不同运动形式下大脑半球相关区域血氧水平的变化。结果　在健侧分别进行主动、被动及加阻力的主动运动时 ,皮层信号区均集中于中央前回第一运动区和中央后回本体感觉区附近 ,重复性强。而当患侧行上述 3种动作模式时 ,在其病变区信号活动明显增强 ,而且可见大脑皮层及皮层下其他部位有兴奋性信号出现。结论　在脑卒中恢复期 ,大脑半球其他部位对其运动功能的改善发挥了作用 ,而且不同的运动模式其参与的部位也不同。运动疗法中的各种手法确实能引起脑组织内的某些信号变化 ,对大脑半球的功能重组产生了积极的作用。Objective To observe the cerebral activation by functional MRI(F MRI) during the thumb movement in different motor fashion. Methods Four stroke patients with hemiplegia were involved in this study During the examination by F MRI, these patients were asked to move thumbs in passive, active and overcoming resistance fashion. Results (1) During the thumb at unaffected side moving in active fashion, functional activity was observed in the contralateral primary motor cortex In passive fashion, however, functional activity was observed in contralateral somatosensory cortex The overcoming resistance motor test was associated with activity in bilateral primary motor cortex and somatosensory cortex (2) The same motor tests were made in movement of the thumb at affected side , functional activity appeared not only in primary motor cortex, somatosensory cortex of affected side, but also in basal ganglia(affected area), frontal lobe, supplementary motor cortex, somatosensory cortex, and contralateral primary motor cortex. Conclusion These results have proved the neurorehabilitation theory such as neuroplasticity and so on

关 键 词：磁共振成像 偏瘫 康复 脑卒中 拇指运动 

分 类 号：R445.2[医药卫生—影像医学与核医学]