大脑脚非对称性比例与中老年优势半球卒中后非优势半球语言、运动功能代偿的相关性研究

doi:10.3969/j.issn.1673-5765.2025.11.011

中国卒中杂志 ›› 2025, Vol. 20 ›› Issue (11): 1420-1427.DOI: 10.3969/j.issn.1673-5765.2025.11.011

大脑脚非对称性比例与中老年优势半球卒中后非优势半球语言、运动功能代偿的相关性研究

杜秀玉¹，郭小川¹，周小宝¹，卢海涛¹，智德豹¹，毛娇²

1 上海 200071 上海中医药大学附属市中医医院神经外科
2 上海中医药大学附属市中医医院康复医学科

收稿日期:2025-02-05 修回日期:2025-10-25 接受日期:2025-11-03 出版日期:2025-11-20 发布日期:2025-11-20
通讯作者: 杜秀玉 dxy8108@163.com
基金资助:
2022年静安区医学科研课题（2022QT01）
上海医学创新发展基金会未来计划（WL-GNDBZPY-2022002K）

Correlation between Asymmetry Rate of Cerebral Peduncle and Compensation of Language and Motor Functions in Non-Dominant Hemisphere after Dominant Hemisphere Stroke in Middle-Aged and Elderly Patients

DU Xiuyu¹, GUO Xiaochuan¹, ZHOU Xiaobao¹, LU Haitao¹, ZHI Debao¹, MAO Jiao²

1 Department of Neurosurgery, Shanghai Municipal Hospital of Traditional Chinese Medicine, Shanghai University of Traditional Chinese Medicine, Shanghai 200071, China
2 Department of Rehabilitation Medicine, Shanghai Municipal Hospital of Traditional Chinese Medicine, Shanghai University of Traditional Chinese Medicine, Shanghai 200071, China

Received:2025-02-05 Revised:2025-10-25 Accepted:2025-11-03 Online:2025-11-20 Published:2025-11-20
Contact: DU Xiuyu, E-mail: dxy8108@163.com

摘要/Abstract

摘要： 目的探讨大脑脚非对称性比例（asymmetry rate of cerebral peduncle，ARCP）与中老年优势半球卒中后非优势半球在语言、运动功能等方面代偿潜力的相关性。
方法回顾性连续收集2022年10月—2024年10月于上海中医药大学附属市中医医院就诊的中老年优势半球卒中后复发卒中患者的临床资料。收集患者复发卒中前后的失语商（aphasia quotient，AQ）、Fugl-Meyer运动功能评定量表（Fugl-Meyer motor assessment scale，FMA）评分及ARCP等指标，观察复发卒中前后上述指标的变化。以ARCP≤0.75和ARCP＞0.75为分组标准，分析两组患者AQ、FMA评分在复发卒中前后的变化特点及其与ARCP的相关性。
结果 17例复发卒中患者中，男性7例，女性10例；年龄为51～80岁；左侧复发卒中6例，右侧复发卒中11例；复发出血性卒中2例，缺血性卒中15例；首次卒中至复发卒中的时间间隔为5～12个月。与复发卒中前相比，9例ARCP≤0.75的右侧复发卒中患者中，AQ下降8.5～59.2分，中位下降值为33.5分；右侧肢体FMA评分下降5～47分，中位下降值为22分；左侧肢体FMA评分下降6～50分，中位下降值为24分。4例ARCP≤0.75的左侧复发卒中患者中，AQ下降0～1.2分，中位下降值为0分；右侧肢体FMA评分下降0～8分，中位下降值为2分；左侧肢体FMA评分下降0～2分，中位下降值为1分。2例ARCP＞0.75的右侧复发卒中患者中，左侧肢体FMA评分下降（分别由100分降至86分、96分降至91分）。2例ARCP＞0.75的左侧复发卒中患者中，1例AQ无变化，1例由96.0分降至76.4分；右侧肢体FMA评分均出现下降（分别由96分降至81分、95分降至72分）。左侧首次卒中后，AQ与ARCP呈正相关（r=0.767，P=0.003）；左侧首次卒中后，右侧肢体FMA评分与ARCP呈正相关（r=0.630，P=0.007）；右侧复发卒中后，AQ与ARCP呈正相关（r=0.835，P=0.001）；右侧复发卒中后，右侧肢体FMA评分与ARCP呈正相关（r=0.773，P=0.005）。
结论中老年优势半球卒中后ARCP≤0.75的患者，其语言及运动功能的恢复与非优势半球代偿密切相关。

文章导读： 中老年优势半球卒中后，健康的非优势半球依然具有语言、运动等功能的代偿潜力。优势半球卒中后大脑脚非对称性比例≤0.75且功能恢复良好的患者提示功能代偿位于非优势半球。

关键词: 大脑脚非对称性比例; 卒中; 失语; 运动功能; 代偿

Abstract: Objective To explore the correlation between asymmetry rate of cerebral peduncle (ARCP) and compensatory potential of language and motor functions in non-dominant hemisphere after dominant hemisphere stroke in middle-aged and elderly patients.
Methods Consecutive retrospective collection was conducted on the clinical data of middle-aged and elderly patients with recurrent stroke after dominant hemispheric stroke, who received treatment at Shanghai Municipal Hospital of Traditional Chinese Medicine, Shanghai University of Traditional Chinese Medicine from October 2022 to October 2024. Indicators including aphasia quotient (AQ), Fugl-Meyer motor assessment scale (FMA) scores, and ARCP were collected before and after recurrent stroke, and changes in the above indicators before and after recurrent stroke were observed. Patients were divided into two groups based on ARCP values (ARCP≤0.75 and ARCP>0.75). The changes in AQ and FMA scores before and after recurrent stroke between the two groups, as well as their correlation with ARCP were analyzed.
Results Among the 17 patients with recurrent stroke, 7 were male and 10 were female, aged 51-80 years. There were 6 cases of left-sided recurrent stroke and 11 cases of right-sided recurrent stroke, including 2 cases of recurrent hemorrhagic stroke and 15 cases of ischemic stroke. The time interval from the first stroke to recurrent stroke was 5 to 12 months. Compared with before recurrent stroke: among the 9 patients with right-sided recurrent stroke and ARCP≤0.75, AQ decreased from 8.5 to 59.2 points, with a median decrease of 33.5 points; FMA scores of the right limb decreased from 5 to 47 points, with a median decrease of 22 points; and FMA scores of the left limb decreased from 6 to 50 points, with a median decrease of 24 points. Among the 4 patients with left-sided recurrent stroke and ARCP≤0.75, AQ decreased from 0 to 1.2 points, with a median decrease of 0 points; FMA scores of the right limb decreased from 0 to 8 points, with a median decrease of 2 points; and FMA scores of the left limb decreased from 0 to 2 points, with a median decrease of 1 point. For the 2 patients with right-sided recurrent stroke and ARCP>0.75, FMA scores of the left limb decreased (from 100 to 86 points, and from 96 to 91 points, respectively). Among the 2 patients with left-sided recurrent stroke and ARCP>0.75, 1 patient had no change in AQ, while the other had AQ decreased from 96.0 to 76.4 points; FMA scores of the right limb decreased in both patients (from 96 to 81 points, and from 95 to 72 points, respectively). A positive correlation was observed between AQ after the first left-sided stroke and ARCP (r=0.767, P=0.003); a positive correlation was found between FMA scores of the right limb after the first left-sided stroke and ARCP (r=0.630, P=0.007); AQ after right-sided recurrent stroke was positively correlated with ARCP (r=0.835, P=0.001); and FMA scores of the right limb after right-sided recurrent stroke were positively correlated with ARCP (r=0.773, P=0.005).
Conclusions For middle-aged and elderly patients with ARCP≤0.75 after dominant hemisphere stroke, the recovery of language and motor functions is closely related to the compensation of the non-dominant hemisphere.

Key words: Asymmetry rate of cerebral peduncle; Stroke; Aphasia; Motor function; Compensation

中图分类号:

杜秀玉, 郭小川, 周小宝, 卢海涛, 智德豹, 毛娇. 大脑脚非对称性比例与中老年优势半球卒中后非优势半球语言、运动功能代偿的相关性研究[J]. 中国卒中杂志, 2025, 20(11): 1420-1427.

DU Xiuyu, GUO Xiaochuan, ZHOU Xiaobao, LU Haitao, ZHI Debao, MAO Jiao. Correlation between Asymmetry Rate of Cerebral Peduncle and Compensation of Language and Motor Functions in Non-Dominant Hemisphere after Dominant Hemisphere Stroke in Middle-Aged and Elderly Patients[J]. Chinese Journal of Stroke, 2025, 20(11): 1420-1427.

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大脑脚非对称性比例与中老年优势半球卒中后非优势半球语言、运动功能代偿的相关性研究

Correlation between Asymmetry Rate of Cerebral Peduncle and Compensation of Language and Motor Functions in Non-Dominant Hemisphere after Dominant Hemisphere Stroke in Middle-Aged and Elderly Patients

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