基于静息态功能磁共振探究高强度间歇运动训练对脑梗死后运动障碍康复的影响

Investigating the impact of high-intensity interval exercise training on motor deficit rehabilitation post-stroke:a resting-state functional magnetic resonance imaging study

目的评估高强度间歇运动训练(high-intensity interval training,HIIT)对改善脑梗死后运动障碍的作用,利用静息态功能磁共振成像探讨相关机制。方法将30例脑梗死恢复期患者随机分为对照组和HIIT组。对照组实施常规康复训练,HIIT组在常规康复训练基础上进行HIIT训练。干预前后采用Fugl-Meyer(FMA)量表评估两组的肢体运动功能,并在干预结束后对受试者进行功能磁共振扫描。结果干预6周后,两组受试者FMA评分均较前明显改善,HIIT组下肢FMA评分高于对照组(P<0.05)。与对照组相比,HIIT训练组右侧中央后回和左侧额下回的DC值增高(P<0.05,FDR校正);HIIT训练组在左侧额下回与右侧海马旁回、右侧颞极、双侧前扣带回、双侧腹内侧前额叶、胼胝体中部之间的连接明显增强(P<0.05,FDR校正)。HIIT组左侧额下回的DC值以及左、右侧腹内侧前额叶的FC值与FMA量表评分的上升均呈正相关(r=0.466,P=0.033;r=0.625,P=0.002;r=0.487,P=0.025)。结论对脑梗死恢复期患者进行HIIT训练可改善神经重塑,促进肢体运动功能恢复。

Objective To evaluate the effects of high-intensity interval training(HIIT)on improving post-stroke motor impairment,and to explore the related mechanisms using resting-state functional magnetic resonance imaging(rs-fMRI).Methods Thirty patients in the stroke recovery period were randomly divided into a control group and a HIIT group.The control group received routine exercise rehabilitation training,while the HIIT group received HIIT training on the basis of routine exercise rehabilitation.The Fugl-Meyer(FMA)scale was used to evaluate the limb motor function of the two groups before and after the intervention,and 10 subjects from each group were selected for MRI scanning after the intervention.Results After 6 weeks of intervention,the FMA score of both groups of subjects were significantly improved compared to before the intervention.Moreover,the lower limb FMA score of the HIIT group was significantly higher than that of the control group(P<0.05).Compared with the control group,the DC values of the right posterior central gyrus and left inferior frontal gyrus in the HIIT group were significantly increased(P<0.05,FDR correction).In addition,the connectivity between the left inferior frontal gyrus and the right parahippocampal gyrus,right temporal pole,bilateral anterior cingulate gyrus,bilateral ventromedial prefrontal cortex,and midbody of the corpus callosum was significantly enhanced in the HIIT training group(P<0.05,FDR correction).The DC value of the left inferior frontal gyrus and the FC values of the left ventromedial prefrontal cortex and right ventromedial prefrontal cortex in the HIIT group were positively correlated with the increase in FMA scores.Conclusion Applying high-intensity interval training for rehabilitation in stroke patients in the recovery period can improve neural remodeling and promote the recovery of limb motor function.