功能磁共振成像在帕金森病患者四肢联动训练时脑功能活动区的协同作用研究

Study on the synergistic effect of functional MRI on brain functional activity areas during limb linkage training in patients with Parkinson's disease

目的 通过采用功能MRI(functional MRI, fMRI)观察帕金森病(Parkinson’s disease, PD)患者四肢联动训练时脑区激活情况,探讨该疗法的干预机制。材料与方法 前瞻性纳入2021年4月至2023年2月在喀什地区第一人民医院就诊的PD患者50例作为病例组,另选取基线资料匹配的健康志愿者30例作为对照组,对两组受试者进行四肢联动时的全脑fMRI扫描。结果 对照组做四肢联动运动时,脑激活区主要有右侧初级感觉运动皮层(sensorimotor cortex, SM1)(t=14.4829, P<0.05),左侧初级感觉运动皮层(t=8.7640, P<0.05),左侧辅助运动区(supplementary motor area, SMA)(t=8.4628, P<0.05),右侧丘脑(t=9.3230, P<0.05),右侧岛叶(t=8.8615, P<0.05),左侧颞上回(t=9.0467, P<0.05)及左侧顶下小叶(t=10.8249, P<0.05)。PD患者做四肢联动运动时,脑激活区主要有右侧SM1(t=10.0234, P<0.05),左侧SMA(t=7.8221, P<0.05),右侧岛叶(t=6.3241, P<0.05),左侧颞上回(t=7.6571, P<0.05)及左侧顶下小叶(t=4.9862, P<0.05)。与对照组对比,PD患者做四肢联动运动时,激活减弱的区域有左侧SMA(t=6.011, P<0.05),右侧岛叶(t=5.610, P<0.05)及左侧颞上回(t=6.781, P<0.05),而激活增强的区域有右侧SM1(t=3.652, P<0.05)。结论 四肢联动训练使PD患者初级运动功能区功能代偿性增强,这对PD患者康复治疗具有理论指导意义。

Objective:To explore he intervention mechanism of limb linkage training on patients with Parkinson's disease(PD)by using functional MRI(fMRI).Materials and Methods:Fifty patients with Parkinson's disease who visited the First People's Hospital of Kashi area from April 2021 to February 2023 were collected as the case group,and 30 healthy volunteers matched with the baseline data were selected as the control group.The whole brain fMRI scanning of the two groups of subjects during limb linkage was performed.Results:In the healthy control group,the brain activation areas mainly include right primary sensory motor cortex(SM1)(t=14.4829,P<0.05),left primary sensory motor cortex(t=8.7640,P<0.05),left auxiliary motor area(SMA)(t=8.4628,P<0.05),right thalamus(t=9.3230,P<0.05),right insular lobe(t=8.8615,P<0.05),left superior temporal gyrus(t=9.0467,P<0.05)and left inferior parietal lobule(t=10.8249,P<0.05).In patients with Parkinson's disease,the brain activation areas mainly include right SM1(t=10.0234,P<0.05),left SMA(t=7.8221,P<0.05),right insular lobe(t=6.3241,P<0.05),left superior temporal gyrus(t=7.6571,P<0.05)and left inferior parietal lobule(t=4.9862,P<0.05).Compared with the healthy control group,the left SMA(t=6.011,P<0.05),the right insular lobe(t=5.610,P<0.05)and the left superior temporal gyrus(t=6.781,P<0.05)were less activated in PD patients while the right SM1(t=3.652,P<0.05)was more activated.Conclusions:Limb linkage training enhances the compensatory function of the primary motor function area in PD patients,which has theoretical guiding significance for the rehabilitation treatment of PD patients.