皮层下脑梗死运动功能自发恢复的功能性近红外光学成像研究

Functional near infrared spectroscopy finding of spontanous recovery of motor function after subcortical infarction

目的评价皮层下脑梗死患者发病后早期运动相关的脑激活部位及其与Fugl—Meyer评分的相关性。方法对发病后14d内的皮层下脑梗死患者和志愿者进行近红外脑功能成像检查。实验采用模块设计、抓握任务，经数据处理、统计和脑功能区定位，比较脑梗死组和对照组激活区域的差别。结果对照组仅激活右侧大脑半球初级感觉运动皮层，脑梗死组还激活左侧初级感觉运动皮层和前额叶，激活范围较对照组广泛（P〈0．01）。Oxy—Hb数据与Fugl—Meyer评分之间的相关性分析差异无统计学意义（P〉0．05）。结论脑梗死发生后早期即可出现皮层功能重组，fNIRS适用于监测卒中后运动相关的脑激活状态。

Objective To evaluate the motor- related activation of cortical regions in patients who suffered hemiparesis after subcortieal infarction in acute phase and relationship between functional near infrared spectroscopy （fNIRS） signal and Fugl - Meyer score. Methods We employed fNIRS to evaluate cortical activation with affected hand movement in 8 patients after subcortical infarction causing mild to moderate left hemiparesis in early phase （≤ 14 days ）. Eight right -handed noimal subjects without stroke history served as controls. Block design of hand grasp task was used. The activated channels were compared between patients and controls. Correlative analysis was performed between fNIRS signal and Fugl - Meyer score in patients. Results The activated cortices in patients were larger than that of controls. Controls activated the right primary sensorimotor cortex （ CH14,8,15,20 和 21, P 〈 0. 01 ） during left hand grasp task. However, patients showed extended activation not only in the right motor cortex（ CH15,8,2,22,3,20, 16,14,27,35,41,1,10和l 36, P 〈0. 01 ）but also in the left motor cortex including prefrontal cortex（ CH5 ~l CH37, P 〈 0. 01 ） during the same task. No statistical correlation was found between fNIRS signal and Fugl - Meyer score. Conclusions Cortical reorganization can be detected early after subcortical infarction by using fNIRS. The result of this study demonstrated that fNIRS was suitable for studying poststroke alterations in cortical response to motor stimulation.