手运动想象对脑卒中患者脑电信号的影响

Effects of hand motor imagery on the EEG signal in stroke patients

目的:分析脑卒中患者健患侧手运动想象(motor imagery,MI)时大脑前运动区(premotor area,PMA)及初级运动皮质(primary motor cortex,M1)的脑电信号特征,明确手运动想象对双侧大脑激活的影响。方法:选取2020年1月—2021年12月于山东大学齐鲁医院康复科住院治疗的脑卒中左侧肢体偏瘫患者18例,采用左右手MI训练,随机想象左右手运动,其中,想象左手运动30次,想象右手运动30次。记录随机MI时,M1区(导联25/26/27/29/30/31)及PMA(导联16/17/18/20/21/22)脑电信号,比较MI时不同脑区激活特点。结果:无论患手或健手MI时,随着PMA脑电信号的增强,同侧M1区相应导联的脑电信号随之增强,呈现明显正相关性(均P<0.05)。患手MI时,PMA激活明显高于M1区(P<0.05),而健手MI对PMA和M1区激活的作用相类似(均P>0.05)。患手或健手MI时,均明显激活健侧M1区(P<0.05),余双侧大脑对应导联之间无显著性差异(P>0.05)。结论:本研究证明MI可同时激活PMA和M1区,而且无论是健侧或患侧MI,均明显激活健侧M1区。

Objective:To investigate the effect of hand motor imagery(MI)by analyzing the electroencephalogram(EEG)characteristics of the premotor area(PMA)and primary motor cortex(M1)in stroke patients.Method:A total of 18 stroke patients with left hemiplegia who were hospitalized in the Rehabilitation Department of Qilu Hospital of Shandong University from January 2020 to December 2021 were selected.The MI on left and right hand was randomly given 30 times on each side.The EEG signals in M1(channel 25/26/27/29/30/31)and PMA(channel 16/17/18/20/21/22)were recorded during the MI on each side of the hand,and the activation characteristics on different brain regions were compared in MI.Result:With the enhancement of the PMA EEG signal in either the affected hand or the healthy hand MI,the EEG signals in the corresponding channel of the ipsilateral M1 were subsequently enhanced,showing a significant positive correlation(all P<0.05).The activation of PMA was significantly higher than M1 activation in the affected hand MI(P<0.05);while the activation of PMA and M1 was similar in the unaffected hand MI(all P>0.05).The M1 of the unaffected brain was significantly activated during MI on both sides(P<0.05),but there was no statistical difference between the remaining corresponding channels of the remaining bilateral brains(P>0.05).Conclusion:MI can activate both PMA and M1.The M1 area in the unaffected brain was obviously activated by either the unaffected or affected side MI.