多靶点神经调控技术对卒中后上肢运动功能障碍患者的脑网络功能连接研究  

Research on brain network functional connectivity of upper limb motor dysfunction patients after stroke using multi-target neuroregulation technology

作　　者：张洪[1] 杨琪 罗静[1] 唐茜[1] 邓鸿 巩文艳 王丽坤 刘静[1] 艾双春[3] Hong Zhang;Qi Yang;Jing Luo;Xi Tang;Hong Deng;Wenyuan Gong;Likun Wang;Jing Liu;Shuangchun Ai(Department of Rehabilitation Medicine,the Third Hospital of Mianyang,Sichuan Mental Health Center,Mianyang 621000,China;Department of Nephrology,the First Hospital of Mianyang,Mianyang 621000,China;Department of Rehabilitation Medicine,Mianyang Traditional Chinese Medicine Hospital,Mianyang 621000,China)

机构地区：[1]绵阳市第三人民医院(四川省精神卫生中心)康复医学科,四川绵阳621000 [2]绵阳市第一人民医院肾病内科,四川绵阳621000 [3]绵阳市中医医院康复医学科,四川绵阳621000

出　　处：《中华脑科疾病与康复杂志(电子版)》2024年第5期278-284,共7页Chinese Journal of Brain Diseases and Rehabilitation(Electronic Edition)

基　　金：四川省卫生健康委员会科研课题(18PJ519);绵阳市卫生健康委员会科研课题(202359);四川省中医药管理局科学技术研究专项课题(2024MS492);中国康复医学会2024年科研课题重点项目计划(KFKT-2024-007)

摘　　要：目的探讨多靶点神经调控技术对脑卒中患者上肢运动功能康复的效果。方法选取绵阳市第三人民医院与绵阳市中医院康复医学科自2021年6月至2022年8月收治的78例脑卒中后伴有上肢运动功能障碍的患者进行前瞻性研究,采用随机数字表法将患者分为试验组和对照组,每组39例。试验组接受高精度经颅直流电刺激多靶点神经调控技术结合常规康复训练,对照组接受相同的康复训练但采用伪刺激,治疗周期为1个月。在治疗前后,采用Fugl-Meyer评定量表上肢部分(FMA-UE)评估上肢运动功能,采用静息状态下功能性近红外光谱技术评估静息状态下脑网络功能连接的变化。结果2组患者治疗后的FMA-UE评分均高于本组治疗前,且试验组高于对照组,差异均有统计学意义(P<0.05)。2组患者治疗后的脑网络连接强度均高于本组治疗前,且试验组高于对照组,差异均有统计学意义(P<0.05)。结论多靶点神经调控技术可显著改善脑卒中患者的上肢运动能力和静息态脑功能网络连接强度。Objective To investigate the effects of multi-target neuroregulation technology on upper limb motor function recovery in stroke patients.Methods A total of 78 patients with upper limb motor dysfunction after stroke admitted to Rehabilitation Medicine Department of the Third Hospital of Mianyang and Mianyang Traditional Chinese Medicine Hospital from June 2021 to August 2022 were selected for this prospective study.Patients were randomly assigned to the experimental group and the control group using a random number table,with 39 patients in each group.The experimental group received high-precision transcranial direct current stimulation multi-target neuroregulation technology combined with conventional rehabilitation training,while the control group received the same rehabilitation training but with sham stimulation.The treatment period was one month.Before and after treatment,upper limb function was assessed using the Fugl-Meyer assessment upper extremity(FMA-UE),and functional near-infrared spectroscopy data were collected during the resting state.Results After training,significant improvements in FMA-UE scores were observed in both groups(P<0.001),with a significantly greater improvement in the experimental group compared to the control group(P<0.05).Before and after training,both groups showed increased brain network connectivity strength,with significantly greater improvement in the experimental group compared to the control group(P<0.05).Conclusion Multi-target neuroregulation technology and conventional rehabilitation training can both enhance upper limb motor function and brain network connectivity in stroke patients.However,compared to traditional rehabilitation methods,multi-target neuroregulation technology has a more significant effect on improving upper limb motor function and resting-state brain functional network connectivity.

关 键 词：脑卒中 上肢运动功能障碍 神经调控 功能性近红外光谱 静息态 脑功能连接 

分 类 号：R743.3[医药卫生—神经病学与精神病学]