基于动态低频振幅的急性基底节区脑梗死后神经功能重塑性研究

Study of nerve function recovery after acute basal ganglia infarction based on dynamic amplitude of low-frequency fluctuations

目的:探讨急性基底节区脑梗死患者脑活动的时间变异性,阐明其对神经功能恢复的意义。方法:纳入广西医科大学第一附属医院神经内科收治的急性基底节区脑梗死患者34例(梗死组)和健康志愿者44例(健康对照组),采用动态低频振幅(d ALFF)分析方法分析比较两组间脑功能活动的差异,并对存在显著差异脑区的dALFF值与美国国立卫生研究员卒中评分(NIHSS)、Fugl-Meyer运动功能评分量表(FMA)进行Spearman相关性分析。结果:与健康对照组比较,急性基底节区脑梗死患者在左侧颞极、海马旁回、枕中回、背侧额上回、扣带回中部及右侧直回、楔前叶的dALFF变异性增加(均P<0.05),右侧直回区域的dALFF值与NIHSS评分呈负相关关系(r=-0.458,P=0.007),与FMA下肢运动功能评分呈正相关关系(r=0.499,P=0.003)。结论:急性基底节区脑梗死患者存在局部脑活动的动态变化,且右侧直回区域的自发脑活动波动增加与急性基底节区脑梗死患者神经功能恢复存在相关性。

Objective:To investigate the temporal variability of brain activity in patients with acute basal ganglia infarction and to elucidate its significance for the recovery of neurological functions.Methods:Thirty-four patients with acute basal ganglia infarction(infarction group)and 44 healthy volunteers(healthy control group)admitted to the Department of Neurology of the First Affiliated Hospital of Guangxi Medical University were included,and the differences in brain functional activity between the two groups were analyzed by dynamic amplitude of low-frequency fluctuations(dALFF)analysis;the dALFF values of brain areas with significant differences were compared with the National Institutes of Health Stroke Scale(NIHSS)and Fugl-Meyer Assessment(FMA)scores for Spearman correlation analysis.Results:Compared with healthy control group,patients with acute basal ganglia infarction had increased dALFF variability in the left temporal pole,parahippocampal gyrus,middle occipital gyrus,dorsal superior frontal gyrus,middle cingulate gyrus,and right rectus gyrus and precuneus(all P<0.05).The d ALFF value in the right rectal gyrus was negatively correlated with NIHSS score(r=-0.458,P=0.007)and positively correlated with FMA lower extremity motor function score(r=0.499,P=0.003).Conclusion:There are dynamic changes of local brain activity and correlation between increased spontaneous brain activity fluctuations in the right rectus gyrus and neurological recovery in patients with acute basal ganglia infarction.