静息态脑电图在脑卒中患者上肢运动功能评估中的应用  

Application of resting-state electroencephalography in assessment of upper limb motor function of stroke patients

作　　者：李鑫磊 魏伟 宋健 赵雨晴 孔维橙 蔡嘉玉 施浩然 薛偕华 LI Xinlei;WEI Wei;SONG Jian;ZHAO Yuqing;KONG Weicheng;CAI Jiayu;SHI Haoran;XUE Xiehua(College of Rehabilitation Medicine,Fujian University of Traditional Chinese Medicine,Fuzhou,Fujian 350003,China;Rehabilitation Hospital Affiliated to Fujian University of Traditional Chinese Medicine,Fuzhou,Fujian 350122,China;Key Laboratory for Cognitive Function Rehabilitation of Fujian Province,Fuzhou,Fujian 350003,China;Key Laboratory of Rehabilitation Technology of Fujian Province,Fuzhou,Fujian 350122,China)

机构地区：[1]福建中医药大学康复医学院,福建福州市350003 [2]福建中医药大学附属康复医院,福建福州市350122 [3]福建省认知功能康复重点实验室,福建福州市350003 [4]福建省康复技术重点实验室,福建福州市350122

出　　处：《中国康复理论与实践》2025年第4期448-457,共10页Chinese Journal of Rehabilitation Theory and Practice

基　　金：福建省认知功能康复重点实验室开放项目(No.XKF2023007);福建中医药大学康复技术省部共建协同创新中心项目(No.X2022005);福建省卫生健康科研项目医学创新课题(No.2024CXA048)。

摘　　要：目的探讨存在上肢活动受限的脑卒中患者的静息态脑电图的电生理特征,并分析其评估脑卒中患者上肢运动功能的应用价值。方法2024年3月至8月,在福建中医药大学附属康复医院招募71例存在上肢活动受限的脑卒中患者作为卒中组,同时招募63例年龄、性别相匹配的健康人作为对照组。采用19导静息态脑电图采集受试者的脑电数据,计算同源电极对的脑对称性指数(pdBSI)和Delta/Alpha比值(DAR)。采用Fugl-Meyer运动评定量表上肢部分(FMA-UE)评估脑卒中患者的上肢运动功能,采用Brunnstrom分期评估脑卒中患者的上肢运动恢复水平,采用改良Barthel指数(MBI)评估脑卒中患者的日常生活活动能力。结果相比对照组,卒中组在全局导联、额叶区域、中央区域和区域的Theta频段的pdBSI提高(|Z|>3.016,P<0.01);全局导联、额叶区域和后部区域的pdBSI Beta2提高(|Z|>3.222,P<0.01);全局导联、额叶区域、中央区域和后部区域的DAR均提高(|Z|>6.565,P<0.001)。卒中组全局导联(r=-0.280,P=0.018)和中央区域(r=-0.304,P=0.010)的pdBSI Delta与FMA-UE评分呈负相关;全局导联(r=-0.289,P=0.014)、中央区域(r=-0.244,P=0.040)和后部区域(r=-0.356,P=0.002)的pdBSI Beta1与FMA-UE评分均呈负相关;全局导联(r=-0.431,P<0.001)、额叶区域(r=-0.429,P<0.001)、中央区域(r=-0.491,P<0.001)和后部区域(r=-0.482,P<0.001)的DAR均与FMA-UE评分呈负相关。结论脑卒中患者存在Delta频段(0.5~4 Hz)和Beta频段(13~20 Hz)的半球间频谱功率不对称性,以中央区域较为明显,并与上肢活动受限相关。pdBSI Delta、pdBSI Beta1和DAR是评估脑卒中患者上肢运动功能的潜在神经电生理标志物。Objective To investigate the features of resting-state electroencephalography(EEG)in stroke patients with limited upper limb movement,and assess its potential utility in evaluating upper limb motor function.Methods From March to August,2024,a total of 71 stroke patients with limited upper limb movement were enrolled as stroke group at the Rehabilitation Hospital Affiliated to Fujian University of Traditional Chinese Medicine;while 63 healthy participants matched for age and sex were recruited as control group.They were tested with 19-channel resting-state EEG(rsEEG),calculating of the pairwise derived brain symmetry index(pdBSI)and Delta/Alpha ratio(DAR).The motor function was assessed with Fugl-Meyer Assessment-Upper Extremities(FMA-UE),the upper limb recovery was evaluated with Brunnstrom Stages and the activities of daily living was assessed with modified Barthel index(MBI)in stroke patients,Results Compared with the control group,the pdBSI of Global lead,Frontal region,Central region and Posterior region across Delta,Alpha and Beta1 frequency bands were significantly higher in the stroke group than in the control group(|Z|>2.289,P<0.05);as well as the pdBSI of Global lead,Central region and Posterior region across Theta bands(|Z|>3.016,P<0.01),the pdBSI of Global lead,Frontal region,Central region and Posterior region across Beta2 bands(|Z|>3.222,P<0.01),DAR of Global lead,Frontal region,Central region and Posterior region(|Z|>6.565,P<0.001).In the stroke group,the pdBSI of Global lead(r=-0.280,P=0.018)and Central region(r=-0.304,P=0.010)across the Delta band were significantly negatively correlated with FMA-UE,as well as the pdBSI of Global leads(r=-0.289,P=0.014),Central region(r=-0.244,P=0.040)and Posterior region(r=-0.356,P=0.002)across the Beta1 band,and the DAR of Global lead(r=-0.431,P<0.001),Frontal region(r=-0.429,P<0.001),Central region(r=-0.491,P<0.001)and Posterior region(r=-0.482,P<0.001).Conclusion Asymmetry in spectral power between hemispheres in the Delta(0.5 to 4 Hz)and Beta(13 to 20 Hz)band

关 键 词：脑卒中 脑电图 上肢 运动功能 

分 类 号：R743[医药卫生—神经病学与精神病学]