事件相关电位在脑卒中偏瘫病人上肢运动时脑电特征研究中的应用  

Application of Event-related Potential in the Characteristics of Electroencephalogram During the Upper Limb Movement in Stroke Patients with Hemiplegia

作　　者：李海 赵江莉[2] 危昔均 王冰水 毛玉瑢[2] 李乐[2] 黄东锋[2,3] LI Hai;ZHAO Jiangli;WEI Xijun;WANG Bingshui;MAO Yurong;LI Le;HUANG Dongfeng(Shenzhen Hospital,Southern Medical University,Shenzhen 518101,Guangdong,China;The First Affiliated Hospital,Sun Yat-sen University,Guangzhou 510080,Guangdong,China;The Seventh Affiliated Hospital,Sun Yat-sen University,Guangzhou 518107,Guangdong,China)

机构地区：[1]南方医科大学深圳医院,广东深圳518101 [2]中山大学附属第一医院,广州510080 [3]中山大学附属第七医院,广东深圳518107

出　　处：《中西医结合心脑血管病杂志》2020年第13期2046-2051,共6页Chinese Journal of Integrative Medicine on Cardio-Cerebrovascular Disease

基　　金：中山大学临床医学研究5010计划项目(No.2014001)。

摘　　要：目的应用脑电事件相关电位(ERP)技术,研究脑卒中偏瘫病人运动过程中脑电活动时域和时频域方面的特征性表现。方法17例脑卒中病人参加脑电ERP试验,试验范式为上肢伸腕运动的指令运动和提示下指令运动。选择初级运动皮层代表区C3、Cz和C4位置,进行两侧及不同ERP范式下运动相关脑电信号的时域和时频域分析。结果患侧指令运动较健侧运动电位(MP)波幅在对侧运动皮层及Cz位置显著增高(P<0.05)。提示后指令运动双侧运动皮层代表区MP波幅差异无统计学意义。患肢提示后指令运动时Cz及损伤对侧皮层MP潜伏期缩短,波幅增高(P<0.05)。事件相关去同步(ERD)平均反应值在不同ERP范式间C3、Cz、C4位置间及两侧运动间比较差异均无统计学意义。结论脑卒中病人患侧上肢运动时受损皮层表现出更大程度的能耗及更广范围的激活,视觉提示可通过激活损伤对侧运动皮层的代偿作用易化运动,ERP技术可应用于脑卒中病人的运动相关脑电活动研究并展示其特征性改变。Objective To study the characteristics of electroencephalogram(EEG)activity in the time domain and time-frequency domain during the upper limb movement in stroke patients with hemiplegia by using event-related potential(ERP)technology.Methods Seventeen stroke patients participated in ERP experiments.Participants performed wrist extension movement directed by the ERP paradigms on conditions with and without visual cues.The locations of C3,Cz,and C4 at the primary motor cortex regions were selected for time-domain and time-frequency domain EEG data analysis on both sides during different ERP experiments.Results In ERP experiments without a visual cue,the MP amplitude during the hemiplegic arm movement was significantly higher at the contralateral motor cortex and Cz than that during the unaffected side movement(P<0.05).In ERP experiments with a visual cue,there was no significant difference in MP amplitude between both side movement.The MP latency was shorter,at Cz and unaffected motor cortex during hemiplegic side cued movement(P<0.05).There were no significant differences in the average response values of event-related desynchronization(ERD)between two sides,at different ERP paradigms,and among C3,Cz,C4 locations.Conclusion In stroke patients,the affected cortex exhibits higher energy consumption and a wider range of activation during the movement of the hemiplegic limb.Visual cues can facilitate movements by activating the compensatory effect of the unaffected motor cortex.ERP technology can be applied to study the movement-related EEG activity and display its characteristic changes in patients with stroke.

关 键 词：脑卒中 偏瘫 事件相关电位 运动相关皮层电位 运动电位 运动相关去同步 脑电变化 

分 类 号：R743[医药卫生—神经病学与精神病学] R255.2[医药卫生—临床医学]