基于功能性近红外光谱技术的卒中后上肢单侧任务与双侧任务的脑功能成像对比观察

doi:10.3969/j.issn.1673-5765.2022.04.007

摘要/Abstract

摘要：

目的通过功能性近红外光谱技术（functional near-infrared spectroscopy，fNIRS）对比卒中患者执行单侧上肢训练任务与双侧上肢训练任务时近红外脑功能成像中氧合血红蛋白的浓度变化以及脑区的激活情况。

方法连续入组2021年1-4月在上海市3家康复医院接受康复治疗的单侧卒中患者，采用便携式近红外脑功能成像设备对患者分别进行单侧（患侧）上肢训练和双侧上肢训练两种不同任务态的近红外观察，比较两种不同任务态下不同脑区氧合血红蛋白的浓度变化和各脑区的激活程度（β值）。

结果纳入统计分析的卒中患者共31例。近红外脑功能成像对比发现，双侧任务时患侧和健侧大脑初级运动皮质区、辅助运动皮质区、初级躯体感觉皮质区及部分前额叶皮质区的β值均高于单侧任务时，差异有统计学意义；双侧任务时患侧和健侧大脑初级运动皮质区、辅助运动皮质区、初级躯体感觉皮质区及部分前额叶皮质区的氧合血红蛋白浓度高于单侧任务时，差异有统计学意义。

结论对比单侧上肢训练，双侧上肢训练对卒中后双侧大脑初级运动皮质区、辅助运动皮质区、初级躯体感觉皮质区的激活更加明显。

文章导读： 卒中后康复训练中针对上肢功能的双侧任务训练较单侧训练对脑区的激活更明显，主要为大脑初级运动、辅助运动和初级躯体感觉等皮质区，提示双侧任务训练可能在促进脑功能重塑方面有积极的作用。

关键词: 卒中; 双侧上肢训练; 单侧上肢训练; 近红外脑功能成像; 氧合血红蛋白

Abstract: Objective To compare the changes of oxyhemoglobin concentration and brain functional activation in stroke patients performing unilateral upper limb training task and bilateral upper limb training task by functional near-infrared spectroscopy (fNIRS). Methods The patients with unilateral stroke who received rehabilitation treatment from three rehabilitation hospitals in Shanghai from January to April 2021 were enrolled in this study. The patients were observed using portable functional near-infrared brain imaging equipment in two different task states: unilateral upper limb training and bilateral upper limb training. The changes of brain oxyhemoglobin concentration and functional activation (β value) of each brain region under the two task states were compared. Results A total of 31 stroke patients were included in the final analysis. The comparison of functional near-infrared brain imaging showed that the β value in the primary motor cortex (M1), supplementary motor area (SMA) and primary somatosensory cortex (S1) at the affected and healthy sides in the patients with bilateral upper limb training were higher than those in the patients with only affected upper limb training, with statistical difference. The mean levels of oxyhemoglobin in the M1, SMA and S1 brain area at the affected and healthy sides in the patients with bilateral upper limb training were higher than those in the patients with only affected upper limb training, with statistical difference.Conclusions Compared with unilateral affected upper limb training, bilateral upper limb training activated bilateral M1, SMA and S1 brain area more significantly after stroke.

Key words: Stroke; Bilateral upper limb training; Unilateral upper limb training; Functional near-infrared brain imaging; Oxyhemoglobin

田婧, 何志杰, 杨青, 刘珏, 贾杰. 基于功能性近红外光谱技术的卒中后上肢单侧任务与双侧任务的脑功能成像对比观察[J]. 中国卒中杂志, 2022, 17(04): 360-364.

TIAN Jing, HE Zhijie, YANG Qing, LIU Jue, JIA Jie. Comparative Observation of Functional Near-Infrared Brain Imaging in Stroke Patients with Unilateral Upper Limb Training and Bilateral Upper Limb Training[J]. Chinese Journal of Stroke, 2022, 17(04): 360-364.

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