康复后周围性面瘫患者初级运动皮层的功能连接变化研究  

Research of functional connectivity of primary motor cortex in recovered patients suffered from bell's palsy

作　　者：薛秋菊[1] 杨骏[2] 李传富[3] 徐春生[3] 武红利[1] 朱一芳[3] 刘军平[3] 

机构地区：[1]安徽中医药大学研究生部,安徽合肥230031 [2]安徽中医药大学第一附属医院针灸康复科,安徽合肥230031 [3]安徽中医药大学第一附属医院影像中心,安徽合肥230031

出　　处：《中国中西医结合影像学杂志》2016年第2期119-124,共6页Chinese Imaging Journal of Integrated Traditional and Western Medicine

基　　金：国家973计划项目(2010CB530505);国家自然科学基金项目(81202768);安徽省自然科学基金项目(1208085MH147);安徽中医药大学青年科学研究项目(2014qn030);安徽中医药大学青年科学临床基金(2015fy008)

摘　　要：目的 :通过分析不同时间康复的周围性面瘫患者初级运动皮层功能连接变化及其与对照组的差异,探讨皮层功能重组在面瘫康复中的作用。方法:选取37例经针灸治疗康复后的左侧周围性面瘫患者作为康复组,根据从发病到康复的时间分为早期康复组(18例,康复时间<45 d)及晚期康复组(19例,康复时间≥45 d);另外选取19例健康志愿者作为对照组。选择双侧面部初级运动皮层(LMI和RMI)作为ROI,比较3组双侧MI功能连接变化。结果:各组间双侧MI功能连接均存在显著差异。与对照组相比,康复组双侧MI与相关脑区的功能连接的减弱脑区主要位于后扣带回、楔前叶、额中回、颞上回、小脑,多与运动、记忆、识别、情感功能相关,局部区域呈增强,如枕中回、顶下小叶;与早期康复组相比,晚期康复组的双侧MI功能连接均显示减弱,减弱的脑区多与感觉运动相关,如运动前区(额上回、额中回)。结论:皮层功能重组在周围性面瘫康复中具有重要作用,即使面瘫患者临床痊愈后,这种皮层功能功能重组依然存在,且面瘫康复所需的时间越长,皮层功能重组的程度越大。Objective：This article aimed to detect cortical reorganization in patients of recovering from peripheral facial paralysis. Methods：37 cases of recovered patients with left side facial palsy and 19 cases of controls were recruited in this study, and the patients were divided into the early group of recovery （18 cases） and the later group of recovery （19 cases） through recovery time of 45 days. Bilateral primary motor cortex （MI） was extracted as region of interest （ROD for functional connectivity analysis. Result：Significant differences were found in intergroup analysis between each group. The recovered group mainly showed significant decreased connectivity of the bilateral MI,eompared to the controls. Significant decreased connectivity was demonstrated in the bilateral MI between the early group and the later group,after being corrected with Monte-Carlo simulation （P=0.001,a〈0.05）. Conclusion：Cortical reorganization plays an important role in recovery of peripheral facial paralysis,and it still exists after clinical recovery with the longer time of recovery, the higher degree of cortical reorganization.

关 键 词：周围性面瘫 功能连接 初级运动皮层 

分 类 号：R246.6[医药卫生—针灸推拿学]