基于功能性近红外光谱技术探索自主排尿相关腹肌运动控制脑功能活动  

Exploring the Functional Brain Activity of Motor Control of Abdominal Muscle Associated with Voluntary Voiding Based on Functional Near-Infrared Spectroscopy

作　　者：施银霜 王梦寰 潘颖颖 林枫[2,3] SHI Yinshuang;WANG Menghuan;PAN Yingying;LIN Feng(School of Rehabilitation Medicine,Nanjing Medical University,Nanjing,Jiangsu 210029,China;The First Affiliated Hospital of Nanjing Medical University,Nanjing,Jiangsu 210029,China;Sir Run Run Hospital,Nanjing Medical University,Nanjing,Jiangsu 211100,China)

机构地区：[1]南京医科大学康复医学院,江苏南京210029 [2]南京医科大学第一附属医院,江苏南京210029 [3]南京医科大学附属逸夫医院,江苏南京211100

出　　处：《康复学报》2024年第3期270-278,共9页Rehabilitation Medicine

基　　金：国家自然科学基金项目(81672255)。

摘　　要：目的在自主排尿过程中腹肌随意收缩是一种运动控制任务,以功能性近红外光谱技术(fNIRS)探索该动作的中枢活动特征。方法招募年龄≥18岁的健康受试者共19例。接受2次fNIRS检测,分别在无尿意及强尿意状态下进行重复腹肌收缩动作。以对应的无腹肌收缩任务下的脑活动为基线,分析这2种不同状态时腹肌收缩特有的脑皮质活动。结果强尿意时腹肌收缩主要激活双侧前运动/辅助运动区(BA6)、双侧背外侧前额叶皮层(BA9/46)、双侧额极区(BA10)、右侧额下回前部(BA47)、右侧颞中回(BA21)、右侧初级运动皮层(BA4)、左侧初级体感皮层(BA1/2/3)与左侧额下回三角部Broca区(BA45)(P<0.05)。无尿意时执行腹肌收缩动作主要激活双侧前运动/辅助运动区(BA6)(P<0.05)、右侧初级运动皮层(BA4)、右侧初级体感皮层(BA1/2/3)、右侧额下回三角部Broca区(BA45)及右侧边缘上回Wernicke区(BA40)(P<0.05)。相比于强尿意状态,无尿意时的主动腹肌收缩动作在双侧前运动/辅助运动区(BA6)存在更强激活(P<0.05)。相比于无尿意状态,强尿意时的腹肌收缩动作在左侧背外侧前额叶皮层(BA46)激活更强(P<0.05)。结论前额叶皮层、初级体感皮层、初级运动皮层、前运动/辅助运动区共同参与调控自主排尿相关腹肌随意收缩。并且在强尿意状态下进行腹肌运动时,可引起前额叶皮层的进一步激活,提示前额叶皮层在感知尿意之后,对于促进腹肌运动和排尿启动具有积极的作用。Objective The contractions of abdominal muscle during voluntary urination is a motor control task,Which aims to explore the central activity characteristics of this action with functional near-infrared spectroscopy(fNIRS).Methods A total of 19 healthy subjects aged 18 years or older were recruited to undergo fNIRS testing twice,performing repetitive abdominal muscle contractions in the no-urine and strong-urine states.Brain activity under the corresponding no-abdominal muscle-contraction task was used as a baseline to analyze the cortical activities specific to abdominal muscle contractions in these two different states.Re‐sults Abdominal muscle contractions during the strong desire to urinate primarily activated the bilateral pre-motor/supplementary motor area(BA6),bilateral dorsolateral prefrontal cortex(BA9/46),bilateral frontal pole area(BA10),the anterior portion of the right inferior frontal gyrus(BA47),the right middle temporal gyrus(BA21),the right primary motor cortex(BA4),and the left primary somatosensory cortex(BA1/2/3)in conjunction with the left inferior frontal of pars triangularis Broca's area(BA45)(P<0.05).In contrast,abdominal muscle contractions with no desire to urinate primarily activated the bilateral pre-motor/supplementary motor area(BA6)(P<0.05),the right primary motor cortex(BA4),the right primary somatosensory cortex(BA1/2/3),the right infe‐rior frontal of pars triangularis Broca's area(BA45),and the right supramarginal gyrus part of Wernicke's area(BA40)(P<0.05).Compared to the strong urination state,stronger activation of the bilateral premotor/assistive motor area(BA6)was present in the non-urination state(P<0.05).Compared to the non-urination state,stronger activation of the left dorsolateral prefrontal cortex(BA46)was present in the strong urination state(P<0.05).Conclusion The primary somatosensory cortex,primary motor cortex,and pre-motor/supplementary motor area are jointly involved in the regulation of voluntary urination-associated random abdominal muscle contractions.And

关 键 词：功能性近红外光谱技术 大脑皮层 腹肌收缩 排尿控制 膀胱 

分 类 号：R493[医药卫生—康复医学] R338[医药卫生—临床医学]