李未,赵阳,王光彬,等.小脑高频重复经颅磁刺激对吞咽神经网络影响的功能性磁共振成像观察[J].中华物理医学与康复杂志,2025,47(5):398-402
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| 小脑高频重复经颅磁刺激对吞咽神经网络影响的功能性磁共振成像观察 |
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| DOI：10.3760/cma.j.cn421666-20231113-00910 |
| 中文关键词: 吞咽 小脑 静息态功能磁共振 重复经颅磁刺激 |
| 英文关键词: Swallowing Cerebellum Functional magnetic resonance imaging Transcranial magnetic stimulation |
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| 中文摘要: |
| 目的 基于功能性磁共振成像技术（fMRI）观察高频重复经颅磁刺激（rTMS）左侧小脑半球对吞咽神经网络的影响。 方法 共招募健康志愿者30例，采用10 Hz rTMS对其左侧小脑半球进行刺激，于磁刺激前、后对所有受试者进行fMRI检查。观察干预前、后受试者下颌舌骨肌运动诱发电位（MEP）波幅以及静息态fMRI数据（ALFF、fALFF、ReHo）变化。 结果 受试者左侧小脑半球经高频rTMS干预后，发现其双侧下颌舌骨肌MEP波幅均显著增加，差异均具有统计学意义（P＜0.001）；干预后受试者左侧小脑区域、枕叶、前额叶、楔叶以及中央前回、中央后回等区域的低频波动振幅（ALFF）、分数低频波动振幅（fALFF）均较干预前显著增加，差异均具有统计学意义（P＜0.05）；另外左侧小脑、枕叶、顶叶、右侧中央前回及中央后回区域的局部一致性（ReHo）水平亦较干预前显著增加，差异均具有统计学意义（P＜0.05）。 结论 10 Hz rTMS刺激左侧小脑半球能明显提高双侧半球吞咽皮质核束的兴奋性，同时中央前回、中央后回、枕叶、楔叶、颞叶、顶下回、右侧前运动皮质、右侧前额叶背外侧皮质等脑区的神经活动亦显著增强，提示小脑组织在吞咽神经网络中发挥重要作用。 |
| 英文摘要: |
| Objective To explore any effect of high-frequency repetitive transcranial magnetic stimulation (rTMS) of the left cerebellar hemisphere on the swallowing neural network using functional magnetic resonance imaging (fMRI). Methods Thirty healthy volunteers were recruited and subjected to 10Hz rTMS of the left cerebellar hemisphere. Before and after the stimulation, fMRI was performed. The amplitude of the motor evoked potential (MEP) of the mylohyoid muscle, the amplitude of its low-frequency fluctuations (ALFFs), their fractional amplitude (fALFF), and their regional homogeneity (ReHo) were observed. Results After the intervention the MEP amplitude of both mylohyoid muscles had increased significantly. The ALFF and fALFF values in the left cerebellar region, occipital lobe, prefrontal lobe, cuneus lobe, anterior central gyrus and posterior central gyrus had increased significantly. And the average ReHo values of the left cerebellum, occipital lobe, parietal lobe, right anterior central gyrus and posterior central gyrus had also significantly increased. Conclusions The stimulation studied can significantly enhance the excitability of bilateral swallowing cortical tracts, as well as the neural activities of the anterior central gyrus, posterior central gyrus, occipital lobe, cuneus lobe, temporal lobe, inferior parietal gyrus, right premotor cortex, and right dorsolateral prefrontal cortex. That suggests that the cerebellum plays an important role in the swallowing neural network. |
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