双任务范式在中枢神经疾病中的应用及研究  

Application and Research of Dual-Task Paradigms in Central Nervous System Diseases

作　　者：李沁议 罗思仪 蒋咏春 陈德龙 赵碧仪 林强 陈泓鑫[1,4] 许方遒 唐贵兵 郑煜欣 LI Qinyi;LUO Siyi;JIANG Yongchun;CHEN Delong;ZHAO Biyi;LIN Qiang;CHEN Hongxin;XU Fangqiu;TANG Guibing;ZHENG Yuxin(The Fifth Affiliated Hospital of Guangzhou Medical University,Guangzhou,Guangdong 510700,China;The Fifth Clinical College,Guangzhou Medical University,Guangzhou,Guangdong 511436,China;Central People's Hospital of Zhanjiang,Zhanjiang,Guangdong 524045,China;Key Laboratory of Biological Targeting Diagnosis,Therapy and Rehabilitation of Guangdong Higher Education Institutes,Guangzhou,Guangdong 510700,China;The First Clinical College,Guangzhou Medical University,Guangzhou,Guangdong 511436,China)

机构地区：[1]广州医科大学附属第五医院,广东广州510700 [2]广州医科大学第五临床学院,广东广州511436 [3]湛江中心人民医院,广东湛江524045 [4]广东高校生物靶向诊治与康复重点实验室,广东广州510700 [5]广州医科大学第一临床学院,广东广州511436

出　　处：《康复学报》2022年第5期462-470,共9页Rehabilitation Medicine

基　　金：国家自然科学基金青年基金项目(81902281);广州市临床特色技术建设项目[2023—2025(No.19)];国家级大学生创新创业计划项目(202110570018);广州医科大学2020—2021大学生创新创业计划(2020A053);广州市卫计委一般引导项目(20211A011106);2022年度广州医科大学学生创新能力提升计划项目(PX-66221494/02-408-2203-2062);科技部国家级重点研发项目(2018YFC2002500)。

摘　　要：在日常生活活动中具备同时完成2个任务或多个任务的能力至关重要。认知-运动双任务范式是指同时执行一个认知任务与一个运动任务,其中的认知任务可根据患者功能缺陷或个体化的康复目标关联不同认知域,运动任务也多选用步行、姿势控制等基础功能性活动。容量有限模型理论是最常见的双任务干扰机制,认知-运动双任务在执行过程中因认知资源有限而产生认知-运动干扰,同时认知-运动干扰受任务难度、任务优先级与自身因素影响,可通过双任务效应量化客观反映双任务有效性。介于双任务训练更接近日常生活活动,目前已被用于中枢神经系统疾病的康复治疗,在改善患者的认知与运动能力方面具有优势,相关临床应用及机制研究的总结具有重要意义。功能性近红外光谱成像技术(fNIRS)作为高时空分辨率、便携无创的脑功能成像技术,突破了对运动环境的限制,满足了双任务模拟日常运动的设备需求,有利于实时测评认知-运动双任务范式下的脑皮质血流动力学变化,被认为是“双任务”研究的重要方法。从双任务干扰机制、认知-运动双任务的常见范式以及fNIRS监测下中枢神经系统疾病的双任务临床应用3个方面作一综述,为双任务范式在中枢神经疾病中的应用及研究提供理论依据。The ability to perform two or more tasks simultaneously in activities of daily living is essential.The cognitive-motor dual-task paradigm refers to the simultaneous performance of a cognitive task and a motor task,where the cognitive task can be asso-ciated with different cognitive domains depending on the patient's functional deficits or individualized rehabilitation goals,and the motor task is mostly selected from basic functional activities such as walking and postural control.The limited capacity model is the most common dual-task mechanism,in which cognitive-motor dual-tasks produce cognitive-motor interference during execution due to limited cognitive resources,while cognitive-motor interference is influenced by task difficulty,task priority,and individual fac-tors,which can be quantified by dual task effect to objectively reflect dual-task effectiveness.Since dual-task training is similar to activities of daily living,it has been used in the rehabilitation of central nervous system(CNS)diseases and has advantages in im-proving patients'cognitive and motor abilities,and it is important to summarize the relevant clinical applications and mechanism studies.Functional near infrared spectroscopy(fNIRS),as a high spatial-temporal resolution,portable,and non-invasive functional brain imaging technique,breaks through the restrictions on the motor environment,meets the equipment requirements of simulating daily activities with dual tasks,and facilitates real-time measurement of cerebral cortical hemodynamic changes in the cognitive-mo-tor dual-task paradigm,which is regarded as an important method for"dual-task"studies.Therefore,this paper presents a review of dual-task interference mechanisms,common paradigms of cognitive-motor dual-tasking,and clinical applications of dual-tasking in CNS diseases under fNIRS monitoring,so as to provide a theoretical basis for the application and research of dual-tasking paradigms in CNS diseases.

关 键 词：认知-运动双任务 功能性近红外光谱成像技术 中枢神经系统疾病 认知-运动干扰 双任务范式 

分 类 号：R741[医药卫生—神经病学与精神病学]