目的研究Fugl-Meyer运动功能评分量表上肢部分(upper Fugl-Meyer motor function assessment,U-FMA)在脑卒中患者镜像康复治疗中的评估作用及与功能独立性评测量表(functional independence measure, FIM)的关系。方法将80例脑卒中后偏...目的研究Fugl-Meyer运动功能评分量表上肢部分(upper Fugl-Meyer motor function assessment,U-FMA)在脑卒中患者镜像康复治疗中的评估作用及与功能独立性评测量表(functional independence measure, FIM)的关系。方法将80例脑卒中后偏瘫的患者随机分为常规康复组(40例)和镜像治疗组(40例)。常规康复组给予常规康复训练,镜像治疗组在常规康复训练的基础上加用镜像疗法;疗程均为24周。治疗前及治疗8、16、24周后采用U-FMA量表评估运动功能、FIM量表评估日常独立活动能力。分析患者运动功能及日常生活活动能力改善程度,并分析两者间的相关性。结果两组治疗8周、16周、24周后,与治疗前U-FMA评分、FIM评分相比,差异有统计学意义(P<0.05)。两组U-FMA评分、FIM评分相比,差异有统计学意义(P<0.05)。相关性分析显示,U-FMA评分与FIM评分呈正相关。结论镜像治疗能够提高脑卒中偏瘫患者上肢运动功能,改善日常生活活动能力。U-FMA量表、FIM量表均能较好反映卒中患者康复后上肢运动功能、日常生活能力改善程度,两者具有良好的相关性。展开更多
Hepatic myelopathy is a complication seen in patients with chronic liver failure with physiologic or iatrogenic portosystemic shunting. The main symptom is progressive lower limb dyskinesia. The role of the brain moto...Hepatic myelopathy is a complication seen in patients with chronic liver failure with physiologic or iatrogenic portosystemic shunting. The main symptom is progressive lower limb dyskinesia. The role of the brain motor control center in hepatic myelopathy is unknown. This study aimed to investigate the gray matter changes in patients with hepatic myelopathy secondary to transjugular intrahepatic portosystemic shunt and to examine their clinical relevance. This was a cross-sectional study. Twenty-three liver failure patients with hepatic myelopathy(hepatic myelopathy group), 23 liver failure patients without hepatic myelopathy(non-hepatic myelopathy group) after transjugular intrahepatic portosystemic shunt, and 23 demographically matched healthy volunteers were enrolled from March 2014 to November 2016 at Xijing Hospital, Air Force Military Medical University(Fourth Military Medical University), China. High-resolution magnetization-prepared rapid gradient-echo brain imaging was acquired. Group differences in regional gray matter were assessed using voxel-based morphometry analysis. The relationship between aberrant gray matter and motor characteristics was investigated. Results demonstrated that compared with the non-hepatic myelopathy group, gray matter volume abnormalities were asymmetric, with decreased volume in the left insula(P = 0.003), left thalamus(P = 0.029), left superior frontal gyrus(P = 0.006), and right middle cingulate cortex(P = 0.021), and increased volume in the right caudate nucleus(P = 0.017), corrected with open-source software. The volume of the right caudate nucleus in the hepatic myelopathy group negatively correlated with the lower limb clinical rating of the Fugl-Meyer Assessment(r = –0.53, P = 0.01). Compared with healthy controls, patients with and without hepatic myelopathy exhibited overall increased gray matter volume in both thalami, and decreased gray matter volume in both putamen, as well as in the globus pallidus, cerebellum, and vermis. The gray matter abnormalities we found predominantly involved motor-related regions, and may be associated with motor dysfunction. An enlarged right caudate nucleus might help to predict weak lower limb motor performance in patients with preclinical hepatic myelopathy after transjugular intrahepatic portosystemic shunt. This study was approved by the Ethics Committee of Xijing Hospital, Air Force Military Medical University(Fourth Military Medical University), China(approval No. 20140227-6) on February 27, 2014.展开更多
Our previous study used regional homogeneity analysis and found that activity in some brain areas of patients with ischemic stroke changed significantly. In the current study, we examined structural changes in these b...Our previous study used regional homogeneity analysis and found that activity in some brain areas of patients with ischemic stroke changed significantly. In the current study, we examined structural changes in these brain regions by taking structural magnetic resonance imaging scans of 11 ischemic stroke patients and 15 healthy participants, and analyzing the data using voxel-based morphometry. Compared with healthy participants, patients exhibited higher gray matter density in the left inferior occipital gyrus and right anterior white matter tract. In contrast, gray matter density in the right cerebellum, left precentral gyrus, right middle frontal gyrus, and left middle temporal gyrus was less in ischemic stroke patients. The changes of gray matter density in the middle frontal gyrus were negatively associated with the clin- ical rating scales of the Fugl-Meyer Motor Assessment （r = -0.609, P = 0.047） and the left middle temporal gyrus was negatively correlated with the clinical rating scales of the nervous functional deficiency scale （r = -0.737, P = 0.010）. Our findings call objectively identify the functional abnormality in some brain regions of ischemic stroke patients.展开更多
文摘目的研究Fugl-Meyer运动功能评分量表上肢部分(upper Fugl-Meyer motor function assessment,U-FMA)在脑卒中患者镜像康复治疗中的评估作用及与功能独立性评测量表(functional independence measure, FIM)的关系。方法将80例脑卒中后偏瘫的患者随机分为常规康复组(40例)和镜像治疗组(40例)。常规康复组给予常规康复训练,镜像治疗组在常规康复训练的基础上加用镜像疗法;疗程均为24周。治疗前及治疗8、16、24周后采用U-FMA量表评估运动功能、FIM量表评估日常独立活动能力。分析患者运动功能及日常生活活动能力改善程度,并分析两者间的相关性。结果两组治疗8周、16周、24周后,与治疗前U-FMA评分、FIM评分相比,差异有统计学意义(P<0.05)。两组U-FMA评分、FIM评分相比,差异有统计学意义(P<0.05)。相关性分析显示,U-FMA评分与FIM评分呈正相关。结论镜像治疗能够提高脑卒中偏瘫患者上肢运动功能,改善日常生活活动能力。U-FMA量表、FIM量表均能较好反映卒中患者康复后上肢运动功能、日常生活能力改善程度,两者具有良好的相关性。
文摘Hepatic myelopathy is a complication seen in patients with chronic liver failure with physiologic or iatrogenic portosystemic shunting. The main symptom is progressive lower limb dyskinesia. The role of the brain motor control center in hepatic myelopathy is unknown. This study aimed to investigate the gray matter changes in patients with hepatic myelopathy secondary to transjugular intrahepatic portosystemic shunt and to examine their clinical relevance. This was a cross-sectional study. Twenty-three liver failure patients with hepatic myelopathy(hepatic myelopathy group), 23 liver failure patients without hepatic myelopathy(non-hepatic myelopathy group) after transjugular intrahepatic portosystemic shunt, and 23 demographically matched healthy volunteers were enrolled from March 2014 to November 2016 at Xijing Hospital, Air Force Military Medical University(Fourth Military Medical University), China. High-resolution magnetization-prepared rapid gradient-echo brain imaging was acquired. Group differences in regional gray matter were assessed using voxel-based morphometry analysis. The relationship between aberrant gray matter and motor characteristics was investigated. Results demonstrated that compared with the non-hepatic myelopathy group, gray matter volume abnormalities were asymmetric, with decreased volume in the left insula(P = 0.003), left thalamus(P = 0.029), left superior frontal gyrus(P = 0.006), and right middle cingulate cortex(P = 0.021), and increased volume in the right caudate nucleus(P = 0.017), corrected with open-source software. The volume of the right caudate nucleus in the hepatic myelopathy group negatively correlated with the lower limb clinical rating of the Fugl-Meyer Assessment(r = –0.53, P = 0.01). Compared with healthy controls, patients with and without hepatic myelopathy exhibited overall increased gray matter volume in both thalami, and decreased gray matter volume in both putamen, as well as in the globus pallidus, cerebellum, and vermis. The gray matter abnormalities we found predominantly involved motor-related regions, and may be associated with motor dysfunction. An enlarged right caudate nucleus might help to predict weak lower limb motor performance in patients with preclinical hepatic myelopathy after transjugular intrahepatic portosystemic shunt. This study was approved by the Ethics Committee of Xijing Hospital, Air Force Military Medical University(Fourth Military Medical University), China(approval No. 20140227-6) on February 27, 2014.
基金financially supported by the National Program on Key Basic Research Project of China(973 Program)No.2012CB518501the National Natural Science Foundation of China,No.81072864
文摘Our previous study used regional homogeneity analysis and found that activity in some brain areas of patients with ischemic stroke changed significantly. In the current study, we examined structural changes in these brain regions by taking structural magnetic resonance imaging scans of 11 ischemic stroke patients and 15 healthy participants, and analyzing the data using voxel-based morphometry. Compared with healthy participants, patients exhibited higher gray matter density in the left inferior occipital gyrus and right anterior white matter tract. In contrast, gray matter density in the right cerebellum, left precentral gyrus, right middle frontal gyrus, and left middle temporal gyrus was less in ischemic stroke patients. The changes of gray matter density in the middle frontal gyrus were negatively associated with the clin- ical rating scales of the Fugl-Meyer Motor Assessment （r = -0.609, P = 0.047） and the left middle temporal gyrus was negatively correlated with the clinical rating scales of the nervous functional deficiency scale （r = -0.737, P = 0.010）. Our findings call objectively identify the functional abnormality in some brain regions of ischemic stroke patients.
