缺血性卒中患者脑运动区域协调性功能影像学研究

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

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。

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.