持续短阵脉冲刺激对健康大脑运动皮层局部一致性和低频振幅的影响  

The effect of continuous theta burst stimulation on amplitude of low-frequency fluctuations and regional homogeneity of healthy motor cortex

作　　者：胡瑞萍 张慧[2] 杨青 朱玉连 汤昕未 范顺娟 吴军发 吴毅 

机构地区：[1]复旦大学附属华山医院康复医学科 [2]华东师范大学物理系上海市磁共振重点实验室

出　　处：《中国康复医学杂志》2017年第10期1108-1113,共6页Chinese Journal of Rehabilitation Medicine

基　　金：上海市科委科技创新行动计划医学领域项目资助(16411955400);上海市卫计委重要薄弱学科建设项目资助(2015ZB0401)

摘　　要：目的:探讨持续短阵脉冲刺激(continuous theta burst stimulation,cTBS)对双侧大脑初级运动皮层(primary motor cortex,M1)区兴奋性的影响。方法:选取21名健康志愿者作为被试,采用经颅磁刺激仪对被试右侧大脑M1区手部支配区进行一次cTBS干预,并分别在cTBS干预前和cTBS干预后即刻进行静息态功能磁共振扫描,比较cTBS干预前后双侧大脑M1区低频振荡振幅(amplitude of low-frequency fluctuations,ALFF)和局部一致性(regional homogeneity,ReHo)、平均局部一致性(mean regional homogeneity,mReHo)的变化。结果:双侧M1区在cTBS干预前后的ReHo、mReHo和ALFF指标均值显著降低(P<0.05);体素水平的比较显示,右侧M1区顶部ALFF显著降低(FWE校正P<0.05);大脑60,61,62亚区ALFF在cTBS干预前后差异显著(前测>后测,P<0.01);54、56、58、60、61亚区的ReHo值在cTBS干预后显著下降,差异具有显著性意义(FDR q<0.05);56、58、60等多个亚区,mReHo差异显著(前测>后测,FDR q<0.05)。结论:cTBS干预后,大脑右侧M1区多个亚区ALFF、ReHo、mReHo下降,表明cTBS能够抑制所刺激侧健康大脑运动皮层的兴奋性,且抑制效应在干预后即刻产生;大脑左侧M1区少量亚区的ALFF、ReHo、mReHo下降,表明cTBS可能同时抑制对侧运动皮层的兴奋性。Objective：To explore the effect of continuous theta burst stimulation （cTBS） on the neurological excitability of both sides of cerebral motor cortex. Method： Twenty-one healthy volunteers were enrolled and each one got a session of cTBS on the right prima- ry motor cortex area by the YRD CCY-Ⅱ transcranial magnetic stimulator. The resting-state of right FDI was scanned before the cTBS and 30min after the cTBS. The ALFF,ReHo and mReHo were compared at the dif- ferent time point. Result：The ReHo,mReHo and ALFF of both sides of M1 decreased significantly after cTBS（P〈O.O5）;The vox- el-based analysis showed the significantly decreased ALFF of right M1 （FWE P〈0.05）;The ALFF of subarea 60,61,62, the ReHo of subarea 54,56,58,60,61, and the mReHo of subarea 56,58,60 decreased significantly too（FDR q〈0.05）.Conclusion： The ALFF, ReHo, mReHo of several subareas of right M1 decreased significantly after cTBS, which indicated that cTBS can inhibit the excitability of ipsilateral healthy motor cortex immediately after the stimulation. The ALFF, ReHo, mReHo of right M I also decreased, which indicated the same inhibitory effect of excitability in the contralateral motor cortex by cTBS.

关 键 词：持续短阵快速脉冲刺激 静息态 低频振荡振幅 低频振荡振幅比率 局部一致性 

分 类 号：R49[医药卫生—康复医学]