急性缺血性脑卒中患者的上肢自发活动及脑电图图论分析研究  

Research on spontaneous upper limb activity and graph theory of electroencephalogram in patients with acute ischemic stroke

作　　者：吴语丝 蒋明清 罗华 阮江海 WU Yusi;JIANG Mingqing;LUO Hua;RUAN Jianghai(Department of Neurology,the Affiliated Hospital of Southwest Medical University,Luzhou,Sichuan,646000)

机构地区：[1]西南医科大学附属医院神经内科,四川泸州646000

出　　处：《实用临床医药杂志》2024年第19期73-78,共6页Journal of Clinical Medicine in Practice

基　　金：国家自然科学基金青年科学基金项目(81804198)。

摘　　要：目的通过双上肢自发活动参数及脑电图图论分析方法,评估急性缺血性脑卒中(AIS)患者运动功能损伤及脑功能网络的变化。方法收集2022年1月—2023年10月在西南医科大学附属医院神经内科就诊的伴上肢运动障碍的34例AIS患者(观察组)和40例健康老年人(对照组)的相关资料。受试者在AIS发病7 d内完成美国国立卫生研究院卒中量表(NHISS)和Fugl-Meyer运动量表(FMA)评估,并持续24 h佩戴腕部活动记录仪(Actiwatch),采集双上肢自发活动数据,分析其相关参数如双上肢协调系数(r)、患侧与健侧上肢活动比(ULAR)等。全部受试者均完成约2 h的19通道脑电图检查,脑电图数据经预处理后提取5段10 s静息状态脑电图,进行图论分析。结果①与健康人群相比,AIS患者δ频段和θ频段均有少量功能连接减弱的边;α频段出现大量网络连接减弱的边缘;在β频段的额区右顶枕区之间仅连接边缘减弱,右侧颞叶到左侧颞叶连接边缘增强;在γ频段中存在全脑大量连接增加的边缘。②在图论分析中,在α、β波段,观察组患者的最短路径长度较对照组显著增加(α段:t=2.228,P<0.05,d=-0.52;β段:t=-3.641,P<0.01,d=-0.878),全局效率显著降低(α段:t=2.535,P<0.05,d=0.591;β段:t=3.321,P<0.01,d=0.803);在γ波段,局部效率(t=3.279,P<0.01,d=0.765)和聚类系数显著更高(t=3.358,P<0.01,d=0.783)。(3)ULAR≤30%组γ段最短路径长度显著降低(t=-2.063,P<0.05,d=-0.802),全局效率(t=2.226,P<0.05,d=0.865)、局部效率(t=2.95。P<0.05,d=1.147)和聚类系数(t=2.962,P<0.05,d=1.148)均显著增高。(4)与对照组相比,观察组睡眠期双上肢协调性系数与NIHSS结果呈负相关(r=-0.389,P<0.05),与ULAR呈负相关(r=-0.395,P<0.05);FMA评分与ULAR呈正相关(r=0.442,P<0.05)。结论上肢自发活动参数可用于判断AIS患者运动功能损伤;脑功能网络改变和运动损伤相结合,可为其神经网络机制研究提供新思路。Objective To evaluate the changes in motor function impairment and brain functional networks of patients with acute ischemic stroke(AIS)through parameters of spontaneous activities of both upper limbs and electroencephalogram graph theory analysis methods.Methods The data of 34 acute ischemic stroke patients(observation group)with upper limb motor disorders who were treated in the Department of Neurology of the Affiliated Hospital of Southwest Medical University from January 2022 to October 2023,and 40 healthy controls(HC group)were collected.The subjects completed the National Institutes of Health Stroke Scale(NIHSS)and Fugl-Meyer Assessment(FMA)within 7 days,and wore wrist activity recorders(Actiwatch)continuously for 24 hours to collect data on spontaneous activities of upper limbs and analyzed related parameters such as the coordination coefficient of both upper limbs(r),the activity ratio of the affected side to the healthy side upper limb(ULAR),etc.At the same time,all subjects completed approximately 2 hours of 19-channel electroencephalogram examination.After preprocessing the electroencephalogram data,5 segments of 10-second resting-state electroencephalogram were extracted for graph theory.Results①Compared to healthy individuals,AIS patients exhibited decreased functional connectivity edges in theδandθbands,with substantial reductions in network connections in theαband.In theβband,connections between the frontal,right parietal,and occipital regions weakened,while connections from the right temporal lobe to the left temporal lobe strengthened.In theγband,there was a significant increase in connections throughout the brain.②Graph theory analysis revealed significantly increased shortest path lengths(αband:t=2.228,P<0.05,d=-0.52;βband:t=-3.641,P<0.01,d=-0.878)and decreased global efficiency(αband:t=2.535,P<0.05,d=0.591;βband:t=3.321,P<0.01,d=0.803)in the observation group compared to the control group.In theγband,local efficiency(t=3.279,P<0.01,d=0.765)and clustering coefficients were signifi

关 键 词：急性缺血性脑卒中 腕部活动记录仪 图论分析 双上肢自发活动 

分 类 号：R743[医药卫生—神经病学与精神病学] R741.044[医药卫生—临床医学] R319