脑卒中后平衡功能障碍小脑蚓部连接变化研究

Investigation on the Changes of Functional Connectivity between Cerebellar Vermis and the Whole Brain in Balance Dysfunction after Stroke

目的观察脑卒中后平衡功能障碍患者小脑蚓部功能连接特点,探索其可能的中枢机制。方法选择卒中后平衡功能障碍患者17例为研究组,另有11例正常平衡功能的健康人为对照组。利用静息态功能核磁共振技术,选择小脑蚓部I~VIII区为感兴趣区与全脑进行相关分析,观察其和全脑的功能连接变化。结果与对照组相比,研究组小脑蚓部与右侧颞下回、右侧中央前回、右侧前额叶、右侧顶下小叶、右侧扣带回、左侧额叶、左侧顶上小叶、双侧小脑后叶的功能连接减弱;与双侧丘脑间的功能连接增加。结论卒中后平衡障碍的患者小脑蚓部与前庭皮质网络、椎体外系皮质中枢的连接减弱,可能是导致其平衡能力下降的中枢机制;与丘脑间的连接增加,可能是脑损伤后机体为维持平衡而产生的感觉代偿。

Objective To investigate the changes of functional connectivity between cerebellar vermis and the whole brain in balance dysfunction after stroke and explore its central mechanism.Methods 17 patients with balance dysfunction after stroke were selected as the study group,and 11 healthy people with normal balance function as the control group.Using resting state fMRI,Ⅰ-Ⅷ region of cerebellar vermis was selected as the region of interest and investigates the changes of functional connectivity between Ⅰ-Ⅷ region of cerebellar vermis and the whole brain.Results compared with the control group.The functional connections between the vermis and the right inferior temporal gyrus,the right anterior central gyrus,the right prefrontal lobe,the right inferior parietal lobule,the right cingulate gyrus,the left frontal lobe,the left superior parietal lobule and the bilateral posterior cerebellar lobes were decreased.The functional connection with bilateral thalamus and cerebellar vermis increased.Conclusion The decreased functional connections between cerebellar vermis and vestibular cortical network/centrum of extravertebral cortex in balance dysfunction after stroke,which The increased functional connections between cerebellar vermis and bilateral thalamus may be a kind of sensory compensation for maintaining balance after brain injury.