被动单指运动的脑激活模式:正常被试者与脑卒中患者的比较

Comparison of the brain activation pattern in passive single finger exercise between a normal testee and a stroke patient

目的:探讨被动单指运动任务在脑卒中急性期功能磁共振成像研究中的应用。方法:应用被动单指运动任务,对2004年6月大庆油田总医院住院的1名急性单侧皮质下梗死患者和1名正常右利手被试进行功能性磁共振成像研究。分析比较正常被试与脑卒中患者被动单指运动的脑激活模式及其异同。结果:正常人被动单指运动激活对侧感觉运动皮质和辅助运动区。脑卒中患者健手运动功能性磁共振成像结果基本同正常人,脑卒中急性期患者患手被动单指运动,依赖双侧感觉运动皮质,运动前区,辅助运动区和同侧后顶叶皮质等脑区的协同参与。结论:正常人双手被动运动和脑卒中患者健手被动运动的脑激活模式与主动运动相似,但患手被动运动则不一样。被动运动为脑卒中急性期运动恢复的功能性磁共振成像研究提供了简便易行的方法。

AIM:To investigate the application of a passive single finger exercise task in the functional magnetic resonance imaging(fMRI) study for acute stroke. METHODS:A patient with unilateral acute subcortical infarction and a normal subject of right handedness,who were hospitalized in the General Hospital of Daqing Oil Field in June 2004,received fMRI with passive single finger exercise task.The modes of brain activation in passive single finger exercise and the differences and similarities were analyzed and compared between normal subjects and stroke patient.RESULTS:For the normal subject, passive single finger exercise of the intact hand activated the contralateral sensorimotor cortex(SMC) and supplementary motor area(SMA).Similar results of fMRI were recorded in the stroke patient during unaffected hand movement. For the stroke patient,the passive single finger exercise of the affected hand depended on bilateral SMC,SMA,premotor cortex(PMC) and ipsilateral posterior parietal cortex.CONCLUSION:The mode of brain activation in passive exercise of both hands in the normal subject and that of the unaffected hand in the stroke patient is essentially identical to those engaged in active exercise,but different activation is observed in the patient during the exercise of the affected hand.Passive exercise offers a convenient and feasible method for the fMRI study of the functional recovery in stroke patients at acute phase.