缺血性卒中患者脑运动区域协调性功能影像学研究

李顶, 王亚, 汪艳芳, 陈焱君, 李金明, 黄文华

doi:10.13418/j.issn.1001-165x.2020.04.006

中国临床解剖学杂志 >

2020 , Vol. 38 >Issue 4: 391 - 395

DOI: https://doi.org/10.13418/j.issn.1001-165x.2020.04.006

断层影像解剖

缺血性卒中患者脑运动区域协调性功能影像学研究

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1.南方医科大学基础医学院, 广州 510515; 2. 广东省医学生物力学重点实验室, 广州 510515;
3. 南方医科大学附属第三医院，广州 510500

李顶（1995-），男，湖北孝感人，硕士在读，专业：生物信息学, Email：liding161616@163.com

收稿日期: 2020-03-26

网络出版日期: 2020-07-29

基金资助

国家重点研发计划（2017YFC1103400）；国家自然科学基金资助项目（81601483）；深圳市医疗卫生“三名工程”高层次医学团队（SZSM201612019）

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Imaging study of regional coordination function of cerebral motor in patients with ischemic stroke

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1. School of Basic Medical Sciences, Southern Medical University, Guangzhou 510515, China; 2. Guangdong Provincial Key Laboratory of Medical Biomechanics, Guangzhou 510515, China; 3. The Third Affiliated Hospital of Southern Medical University, Guangzhou 510500, China

Received date: 2020-03-26

Online published: 2020-07-29

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摘要

目的　评估缺血性脑卒中患者颅脑神经解剖学与脑区功能学的关联性，进一步挖掘缺血性卒中发生的神经机制。方法　采集15例健康对照组和19例亚急性缺血性脑卒中上肢偏瘫患者，利用计算神经影像学计算个性化颅脑内部半球功能连接指标，采集治疗前后临床康复评分作统计相关分析。结果　（1）与对照组相比，卒中患者大脑半球功能连接显著降低，差异有统计学意义(T=-10.077, P<0.001)；（2）病灶异常集中于补充运动区（P=0.02）和中央前回(P=0.03)，差异有统计学意义；（3）药物治疗前后患者组中央前回中的功能连接值与康复评分量表呈正相关，差异有统计学意义（r=0.29，P=0.03）。结论　皮质下缺血性脑卒中患者大脑运动区域的半球间功能连接减少，可作为临床诊断和康复评估提供新的途径。

关键词： 缺血性卒中; 　断层影像; 　功能连接; 　皮层运动区; 　康复评分

本文引用格式

李顶, 王亚, 汪艳芳, 陈焱君, 李金明, 黄文华 . 缺血性卒中患者脑运动区域协调性功能影像学研究[J]. 中国临床解剖学杂志, 2020 , 38(4) : 391 -395 . DOI: 10.13418/j.issn.1001-165x.2020.04.006

Abstract

Objective　To evaluate the correlation between craniocerebral neuroanatomy and regional brain function in patients with ischemic stroke, and to further explore the neural mechanism of ischemic stroke.　Methods　15 healthy patients in a control group and 19 patients with upper limb hemiplegia in subacute ischemic stroke were collected. The functional connection index of the internal craniocerebral hemisphere was calculated by using computational neuroimaging, and the clinical rehabilitation score before and after treatment was collected for statistical correlation analysis.　Results　(1) Compared with the control group, cerebral hemispheric functional connectivity significantly reduced in stroke patients, with statistically significant differences (T=-10.077, P<0.001). (2) The abnormal focus of lesions was in the supplementary motor area (P=0.02) and the anterior central gyrus (P=0.03), and the difference was statistically significant. (3) The functional connection value in the anterior central gyrus of the patient group before and after drug treatment was positively correlated with the rehabilitation scoring scale, and the difference was statistically significant (r=0.29, P=0.03).　Conclusions　The decrease of functional connections of hemispheres in cerebral motor areas in patients with subcortical ischemic stroke may provide a new approach for clinical diagnosis and rehabilitation evaluation.

Key words： Ischemic stroke; 　Tomography; 　Functional connectivity; 　Cortical motor area; Rehabilitation score

参考文献

[1] Freedman B, Potpara TS, Lip GY. Stroke prevention in atrial fibrillation[J]. The Lancet, 2016, 388(10046): 806-817.
[2] Goyal M, Demchuk AM, Menon BK. Randomized assessment of rapid endovascular treatment of ischemic stroke[J]. N Engl J Med, 2015, 372(11):1019-1930.
[3] Gorelick PB, Scuteri A, Black SE, et al. Vascular contributions to cognitive impairment and dementia: a statement for healthcare professionals from the american heart association/american stroke association[J]. stroke, 2011, 42(9): 2672-2713.
[4] Román GC, Erkinjuntti T, Wallin A, et al. Subcortical ischaemic vascular dementia[J]. Lancet Neurol, 2002, 1(7): 426-436.
[5] Zhang Y, Liu H, Wang L, et al. Relationship between functional connectivity and motor function assessment in stroke patients with hemiplegia: a resting-state functional MRI study[J]. Neuroradiology, 2016, 58(5): 503-511.
[6] Zheng XH, Sun LM, Yin DZ,et al. The plasticity of intrinsic functional connectivity patterns associated with rehabilitation intervention in chronic stroke patients[J]. Neuroradiology, 2016, 58(4): 417-427.
[7] Page SJ, Fulk GD, Boyne P. Clinically important differences for the upper-extremity Fugl-Meyer Scale in people with minimal to moderate impairment due to chronic stroke[J]. Phys Ther, 2012, 92(6): 791-798.
[8] Winters C, van Wegen EE, Daffertshofer A, et al. Generalizability of the Proportional Recovery Model for the Upper Extremity After an Ischemic Stroke[J]. Neurorehabil Neural Repair, 2015, 29(7): 614-622.
[9] Lam TK, Dawson DR, Honjo K, et al. Neural coupling between contralesional motor and frontoparietal networks correlates with motor ability in individuals with chronic stroke[J]. J Neurol Sci, 2018, 384:21-29.
[10]Chao-Gan Y, Yu-Feng Z. DPARSF: A MATLAB Toolbox for "Pipeline" Data Analysis of Resting-State fMRI[J]. Front Syst Neurosci, 2010, 4: 13.
[11]Li Y, Wang D, Zhang H, et al. Changes of brain connectivity in the primary motor cortex after subcortical stroke: a multimodal magnetic resonance imaging study[J]. Medicine (Baltimore), 2016. 95(6): e2579.
[12]Klingbeil J, Wawrzyniak M, Stockert A, et al. Resting-state functional connectivity: An emerging method for the study of language networks in post-stroke aphasia[J]. Brain Cogn, 2019, 131: 22-33
[13]Kelly C, Zuo XN, Gotimer K, et al. Reduced interhemispheric resting state functional connectivity in cocaine addiction[J]. Biol Psychiatry, 2011, 69(7): 684-692.
[14]Kalinosky BT, Barillas RB, Schmit BD. Structurofunctional resting-state networks correlate with motor function in chronic stroke[J]. Neuroimage Clin, 2017, 16: 610-623.
[15]Li S. Spasticity, motor recovery, and neural plasticity after stroke[J]. Front Neurol, 2017, 8: 120.
[16]Zuo XN, Kelly C, Martino AD, et al. Growing together and growing apart: regional and sex differences in the lifespan developmental trajectories of functional homotopy[J]. J Neurosci, 2010, 30(45): 15034-15043.
[17]Itabashi R, Nishio Y, Kataoka Y, et al. Damage to the left precentral gyrus is associated with apraxia of speech in acute stroke[J]. Stroke, 2016, 47(1): 31-36.

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