缺血性卒中偏瘫患者静息态脑功能连接强度的磁共振研究  

A study on resting-state brain functional connectivity strength in ischemic stroke hemiplegia patients

作　　者：宋赣军 徐高强 刘军委 周知微 吴琼 Song Ganjun;Xu Gaoqiang;Liu Junwei;Zhou Zhiwei;Wu Qiong(Department of Radiology,Affiliated Hospital of Zunyi Medical University,Zunyi Guizhou 563099,China;Department of Neurology,Affiliated Hospital of Zunyi Medical University,Zunyi Guizhou 563099,China;School of Nursing,Affiliated Hospital of Zunyi Medical University,Zunyi Guizhou 563099,China)

机构地区：[1]遵义医科大学附属医院放射科,贵州遵义563099 [2]遵义医科大学附属医院神经内科,贵州遵义563099 [3]遵义医科大学附属医院护理学院,贵州遵义563099

出　　处：《遵义医科大学学报》2024年第1期76-82,共7页Journal of Zunyi Medical University

基　　金：贵州省中医药管理局项目(NO:QZYY-2021-116);遵义市联合基金项目[NO:遵市科合字(2021)116,NO:遵市科合字(2021)151]。

摘　　要：目的 探讨缺血性脑卒中(CIS)偏瘫患者全脑体素水平的静息态功能连接强度(FCS)改变,分析CIS偏瘫患者神经功能损伤和运动功能与全脑FCS的相关性。方法 对30例缺血性卒中偏瘫患者(CIS组)和30名年龄、性别和受教育程度相匹配的正常志愿者(健康组)进行静息态功能磁共振(rs-fMRI)扫描,经数据处理后得到全脑FCS图,同时对患者进行神经功能损伤(NIHSS)评分和Fugl-Meyer运动功能评估(FMA)。运用两独立样本t检验比较两组间FCS差异,CIS患者异常脑区FCS值与NIHSS、FMA的关系采用Spearman相关分析。结果 与健康组相比,CIS组在右中央前回、双侧中央后回、右缘上回、右额中回、右中央沟盖、双侧内额上回、双侧辅助运动区FCS值显著降低(AlphaSim校正,团块水平P<0.05)。CIS患者右侧中央前回(rs=-0.467,P=0.009)、右内侧额上回(rs=-0.455,P=0.012)和右侧缘上回(rs=-0.434,P=0.017)的FCS值与NIHSS呈负相关,右侧中央前回(rs=0.482,P=0.007)与FMA呈正相关。结论 CIS偏瘫患者多个感觉运动相关脑区的FCS发生改变,这有助于揭示CIS偏瘫后大脑感觉运动功能重塑的神经机制。Objective To investigate the changes in resting-state functional connectivity strength(FCS)at the whole-brain voxel level in patients with cerebral ischemic stroke(CIS)hemiplegia,and to analyze the correlation between neurofunctional impairment and motor function with whole-brain FCS in CIS patients.Methods Resting functional magnetic resonance imaging(rs-fMRI)scans were performed on 30 patients with ischemic stroke hemiplegia(CIS group)and 30 normal volunteers(healthy group)matched in age,gender,and education level.Whole-brain FCS maps were obtained after data processing.Neurofunctional impairment was assessed using the National Institutes of Health Stroke Scale(NIHSS),and motor function was evaluated using the Fugl-Meyer Assessment(FMA).Independent sample t-tests were used to compare FCS differences between the two groups.The relationship between FCS values of abnormal brain regions and NIHSS and FMA in the CIS group was assessed using Spearman correlation analysis.Results Compared to the healthy control group,the CIS group showed significantly reduced FCS values in the right precentral gyrus,bilateral postcentral gyrus,right superior frontal gyrus,right middle frontal gyrus,right central sulcus,bilateral superior frontal gyrus,and bilateral supplementary motor area(AlphaSim correction,cluster level P<0.05).In CIS patients,FCS values in the right precentral gyrus(rs=-0.467,P=0.009),right medial superior frontal gyrus(rs=-0.455,P=0.012),and right superior frontal gyrus(rs=-0.434,P=0.017)were negatively correlated with NIHSS scores.The right precentral gyrus(rs=0.482,P=0.007)showed a positive correlation with FMA scores.Conclusion Functional connectivity strength in several sensorimotor-related brain regions was altered in CIS-induced hemiplegic patients.This contributes to the understanding of the neural mechanisms underlying the reshaping of sensory and motor functions after CIS-induced hemiplegia.

关 键 词：缺血性卒中 偏瘫 静息态功能磁共振成像 功能连接 

分 类 号：R816.1[医药卫生—放射医学]