皮质下脑卒中对运动想象有关脑区功能连接的影响

The effect of subcortical stroke on motor imagery-related cortex functional connectivity

目的:本研究拟运用静息态功能磁共振成像探讨皮质下脑卒中患者运动想象有关脑区功能连接状况。方法:对24例病灶位于左侧运动通路的皮质下脑卒中患者和年龄、性别相匹配的24例正常对照进行静息态脑功能磁共振成像扫描,以病变侧(左侧)顶下小叶为种子点,计算它与其他脑区的功能连接,利用双样本t检验对比分析两组受试者静息态功能连接差异。结果:与正常对照比较,脑卒中组的运动想象相关脑区之间功能连接发生显著变化。脑卒中组病变侧顶下小叶与病变对侧脑功能连接显著下降,涉及的脑区(顶下小叶、辅助运动皮质、运动前区、额下回岛盖部和枕中回)多于病变同侧(辅助运动皮质和运动前区);顶下小叶与病变同侧的额下回岛盖部和双侧小脑外侧部的功能连接显著增加。结论:静息态磁共振成像功能连接分析成功显示皮质下脑卒中导致运动想象相关脑区功能连接受损的客观存在。

Objective： To investigate motor imagery-related cortex functional connectivity of subcortical stroke patient, via task-based functional magnetic resonance imaging （fMRI）. Method： Twenty-four patients with subcortical stroke on the left motor pathway and 24 health controls with matched gender and age were performed resting-state fMRI examination. Selecting the inferior parietal lobule as the seed point and calculating its functional connectivity with other cortex, the difference of resting-static functional connectivity between the two groups was calculated with paired t-test. Result： Comparing with heath controls, stroke patients showed significant variation of functional connectivity in motor imagery related brain areas. The decreased functional connectivity with the ipsilateral IPL located mainly in the contralateral cerebral hemisphere, including the inferior parietal lobe, supplementary area premotor cor- tex, pars opercularis of inferior frontal gyms, and middle occipital gyms. The decrease was less in the ipsilater- al supplementary area and premotor cortex. Conversely, functional connectivity between the inferior parietal lob- ule and pars opercularis of inferior frontal gyms and bilateral cerebellum increased in stroke patients. Conclusion： Impairment of motor imagery-related cortex functional connectivity in subcortical stroke patients was proved by resting-state fMRI functional connectivity analysis.