小脑与卒中后运动学习关系的研究进展

doi:10.3969/j.issn.1673-5765.2021.12.017

摘要/Abstract

摘要： 运动学习强调引导患者主动练习缺失的运动功能，获得尽可能接近正常的运动技能，这种学习过程由小脑和大脑皮层的共同作用来完成。卒中后的功能恢复是运动再学习的过程，康复锻炼的一个重要机制是基于细胞可塑性的运动学习，而小脑在运动学习过程中发挥着不可替代的作用。神经生理学研究表明，小脑中参与运动学习最主要的细胞是浦肯野细胞和颗粒细胞。小脑-皮质通路涉及运动控制和运动学习，使得小脑成为神经调节和治疗卒中后运动障碍的重要靶点。本文就小脑运动学习的细胞机制和针对小脑的刺激技术对卒中后运动功能恢复的作用进行综述。

文章导读： 卒中后神经系统的再学习能力对功能的恢复至关重要，小脑可以通过多种神经递质和环路参与再学习的过程，目前临床上已经开始探索以小脑为靶点的卒中康复治疗措施。

关键词: 小脑; 运动学习; 康复; 经颅磁刺激; 经颅直流电刺激; 低强度聚焦超声; 深部脑刺激

Abstract: Motor learning emphasizes that the patients gain motor skills as close to normal as possible through active exercise of lost motor functions. This learning process is accomplished by the collaboration of cerebellum and cerebral cortex. Neurological function recovery after stroke is a process of motor relearning. An important mechanism of rehabilitation exercise is neuronal plasticity-based motor learning, and the cerebellum plays an irreplaceable role in the process of motor learning. Studies on neurophysiology showed that Purkinje cells and granulosa cells are the most important cells involving in motor learning process in cerebellum. The cerebellum-cortical pathway involves motor control and motor learning, which makes the cerebellum an important target for neuromodulation and treatment of movement disorders after stroke. This article reviewed the cellular mechanisms of cerebellar motor learning and effects of cerebellar stimulation treatment on motor function recovery after stroke.

Key words: Cerebellum; Motor learning; Rehabilitation; Transcranial magnetic stimulation; Transcranial direct current stimulation; Low-intensity focused ultrasound; Deep brain stimulation

林丽珍, 范杰诚, 朱新蕊, 贾凡, 郭培武, 王昱凯, 张淑云. 小脑与卒中后运动学习关系的研究进展[J]. 中国卒中杂志, 2021, 16(12): 1296-1301.

LIN Lizhen, FAN Jiecheng, ZHU Xinrui, JIA Fan, GUO Peiwu, WANG Yukai, ZHANG Shuyun. Progress in the Relationship between Cerebellum and Motor Learning after Stroke[J]. Chinese Journal of Stroke, 2021, 16(12): 1296-1301.

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