王颖,蒲昱帆,王辉煌,等.基于功能性近红外光谱成像技术观察左侧脑卒中后吞咽障碍患者的皮质功能变化[J].中华物理医学与康复杂志,2025,47(8):734-739
扫码阅读全文
|
| 基于功能性近红外光谱成像技术观察左侧脑卒中后吞咽障碍患者的皮质功能变化 |
|
| |
| DOI：10.3760/cma.j.cn421666-20241008-00818 |
| 中文关键词: 吞咽障碍 脑卒中 功能性近红外光谱成像技术 |
| 英文关键词: Dysphagia Stroke Functional near-infrared spectroscopy |
| 基金项目:国家自然科学基金项目（82105004） |
|
| 摘要点击次数: 90 |
| 全文下载次数: 78 |
| 中文摘要: |
| 目的 利用功能性近红外光谱成像技术（fNIRS）分析并比较左侧大脑半球脑卒中后吞咽障碍（PSD）患者与健康人群大脑皮质功能的区别。 方法 招募26例左侧脑卒中后存在吞咽障碍的恢复期患者（PSD组）和26名年龄匹配的健康受试者（HC组），采用41通道fNIRS设备采集2组受试者在吞咽任务中和静息状态下的氧合血红蛋白（HbO）浓度变化。使用Nirspark软件对fNIRS评估结果进行统计分析，通过该软件提取β值以反映大脑皮质激活水平，并计算吞咽相关的特异性功能连接（FC）强度值（ΔFC），以反映吞咽特异性FC强度。对2组受试者的β值和ΔFC进行比较和分析。 结果 与HC组相比，PSD组患者在执行吞咽任务时，左侧Brodmann 分区（BA）3/4/6/43、BA4/6的激活水平降低（P<0.05），相应位置为左侧的初级运动皮质（M1）、初级躯体感觉皮质（S1）、前运动皮质和辅助运动区（PM）；同时，PSD患者右侧BA45/46/47、BA45/38/48、BA10的激活水平降低（P<0.05），相应位置为右侧的前额叶皮质（PFC）。PSD组患者左侧PM-左侧M1、左侧PM-左侧S1、左侧M1-右侧S1及左侧S1-右侧M1之间的ΔFC显著低于HC组（P<0.05）。 结论 左侧大脑半球PSD不仅与患侧运动感觉皮质（M1、S1、PM）的激活减弱有关，还与对侧PFC功能下降相关联。在吞咽任务中，左侧大脑半球PSD患者表现出皮质间网络连接的广泛损伤，其中以患侧与对侧运动感觉皮质之间的连接性减弱最为明显。 |
| 英文摘要: |
| Objective To analyze and compare differences in cortical functioning between patients with post-stroke dysphagia (PSD) following a left hemisphere stroke and healthy individuals using functional near-infrared spectroscopy (fNIRS). Methods Twenty-six patients recovering from post-stroke dysphagia following a left hemisphere stroke formed the study′s PSD group, and 26 age-matched healthy subjects serves as the HC group. A 41-channel infrared spectroscope was used to record any changes in oxyhemoglobin (HbO) concentration while swallowing and at rest. The fNIRS data were statistically analyzed using Nirspark software. The β-values, reflecting the level of cortical activation, and the swallowing-related specific functional connectivity (FC) strength values (ΔFCs), representing task-specific FC strength, were extracted. The β-values and ΔFCs of the two groups were compared. Results Compared with the HC group, the PSD group showed significantly reduced activation in Brodmann area (BA) 3/4/6/43 and BA4/6 of the left hemisphere during swallowing. Those areas correspond to the left primary motor cortex (M1), primary somatosensory cortex (S1), premotor cortex, and supplementary motor area (PM). Significantly reduced activation was observed in the PSD group in the right hemisphere at BA45/46/47, BA45/38/48, and BA10, corresponding to the right prefrontal cortex (PFC). The ΔFC values between the left PM-left M1, left PM-left S1, left M1-right S1, and left S1-right M1 in the PSD group were significantly lower than those in the HC group. Conclusions Left hemispheric PSD is associated not only with decreased activation in the ipsilesional sensorimotor cortex (M1, S1, PM) but also with functional decline in the contra-lesional PFC. During swallowing, persons with left hemispheric PSD exhibit extensive impairment in inter-cortical network connectivity, with particularly marked reductions in connectivity between their ipsilesional and contra-lesional sensorimotor cortices. |
|
查看全文
查看/发表评论 下载PDF阅读器 |
| 关闭 |
|
|
|
