基于功能近红外光谱探讨上肢获益对扩现象的神经行为学机制

Neurobehavioral Mechanism of Cross-Education Phenomenon in the Upper Limb Based on Functional Near-Infrared Spectroscopy

目的基于功能近红外光谱(fNIRS)探索上肢获益对扩(CE)现象及其不对称性的神经行为学机制。方法选择2023年11月—2024年1月南京医科大学附属逸夫医院招募的健康受试者17例,采用随机交叉试验,以评估侧上肢的对侧上肢普渡钉板组装任务(PPT)训练为对侧训练,限时完成的普渡钉板插件数量为任务表现。通过fNIRS分别采集右利手健康受试者的左手和右手在对侧训练后执行操作活动时的脑血流变化并记录行为学数据,比较左、右侧手在对侧训练前后的大脑皮层激活以及行为学表现。结果对侧训练后,受试者左手执行操作任务的表现明显优于训练前(t=-8.865,P<0.010),而右手在训练后的任务表现无明显变化(t=-1.689,P=0.606)。此外,对侧训练后受试者执行左手PPT时的左侧运动前区/辅助运动区(CH 29)、右侧运动前区/辅助运动区(CH 16,CH 17)和右侧初级运动皮层(CH 09)相较于训练前显著激活(P<0.05);而执行右手PPT时的右侧运动前区/辅助运动区(CH 19)、右侧初级躯体感觉皮层(CH 08)和右侧初级运动皮层(CH 10)与训练前激活程度呈现降低趋势(P<0.05)。结论上肢CE现象存在不对称性,表现为非优势手的获益程度优于优势手;CE可能是通过促进双侧运动前区/辅助运动区(pSMA)的皮层激活以改善非训练侧肢体的任务表现。

Objective To explore the neurobehavioral mechanism of cross-education phenomenon and asymmetry in the up‐per limb based on functional near-infrared spectroscopy(fNIRS).Methods A total of 17 healthy subjects recruited by Sir Run Run Hospital of Nanjing Medical University from November 2023 to January 2024 were selected in a randomized cross-over trial.Pur‐due pegboard training with the contralateral upper limb of unilateral limb was taken as the contralateral training,and the number of Purdue pegboard plug-ins completed within a limited time as the task performance.fNIRS was used to collect the cerebral hemody‐namic changes of healthy right-handed individuals after contralateral training when the left and right hand performed operational ac‐tivities and record the behavioral data,and compare the cerebral cortex activation and behavioral performance of the left and right hands before and after contralateral training.Results After contralateral training,the performance of the left hand was significantly better than that before training(t=-8.865,P<0.010),while the performance of the right hand did not change after training(t=-1.689,P=0.606).In addition,the left pre-motor and supplementary motor area(CH 29),right pre-motor and supplementary motor area(CH 16,CH 17)and right primary motor cortex(CH 09)were more significantly activated after contralateral training when subjects per‐formed the Purdue pegboard task with left hand(P<0.05).However,the right pre-motor and supplementary motor area(CH 19),right primary somatosensory cortex(CH 08)and right primary motor cortex(CH 10)showed a decreasing trend in the activation after contralateral training when subjects performed the Purdue pegboard task with right hand(P<0.05).Conclusion Cross-educa‐tion of the upper limbs is asymmetrical,indicating that the non-dominant hand experiences greater benefits compared to the domi‐nant hand.Cross-education may be attributed to enhance the cortical activation of the bilateral pre-motor and supplementary motor area(pSMA)to improve the task performance of the non-training limb.