唐溧峰,李晓寒,康吉良,等.慢性脑卒中患者执行运动-认知双任务时脑血流动力学变化的研究[J].中华物理医学与康复杂志,2026,48(2):119-127
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| 慢性脑卒中患者执行运动-认知双任务时脑血流动力学变化的研究 |
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| DOI：10.3760/cma.j.cn421666-20250408-00312 |
| 中文关键词: 双重任务 功能性近红外光谱 脑卒中 脑血流动力学 认知功能 |
| 英文关键词: Dual-tasking Functional near-infrared spectroscopy Stroke Cerebral hemodynamics Cognition |
| 基金项目:国家重点研发计划 (2024YFB3814100)；宁波市公益性科技计划重点项目 (2024S036)；宁波市 “科创甬江 2035” 重大应用示范场景项目 (2025Z196) |
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| 中文摘要: |
| 目的 采用功能性近红外光谱技术 (fNIRS) 观察脑卒中患者在执行运动 - 认知双任务时的脑血流动力学变化。方法 募集符合标准的脑卒中患者 36 例，男 18 例，女 18 例，采用简单随机法分别完成 5 项任务：单任务（步行 60s 和计算 60s）、顺序性双任务（步行 30s 后计算 30s 和计算 30s 后步行 30s）和同时性双任务（步行与计算同步进行 60s）。使用 fNIRS 测量大脑皮质脑血流动力学，跑台收集步态特征。结果 5 项任务可诱发不同程度大脑激活，fNIRS 结果显示，左、右侧前额叶和运动区激活差异显著，单任务激活水平显著低于顺序性双任务和同时性双任务（P<0.05）；顺序性双任务中，先步行后计算任务的平均功能连接强度显著高于先计算后步行任务（P<0.05）。步态分析显示，单任务和顺序性双任务（先步行后计算）的步速分别为 (33.65±6.22) cm/s 和 (32.21±8.84) cm/s，均显著高于同时性双任务的 (24.37±10.33) cm/s（P<0.05）。结论 慢性脑卒中患者执行顺序性双任务和同时性双任务时，前额叶和运动皮质的激活程度显著高于单任务，任务难度和顺序变化显著影响步态表现。 |
| 英文摘要: |
| Objective To document any changes in the cerebral hemodynamics among stroke survivors performing dual motor-cognitive tasks. Methods Thirty-six stroke survivors (18 males and 18 females) performed five tasks in a randomized order. They included single tasks (walking or calculating for 60s), walking for 30s followed by calculating for 30s, or vice versa, or dual-tasking (calculating while walking for 60s). Functional near-infrared spectroscopy (fNIRS) was used to track the hemodynamics in the cerebral cortex during these tasks. Gait characteristics were also collected using a treadmill. Results All five tasks induced varying degrees of cerebral activation. The fNIRS revealed significant differences in activation between the left and right prefrontal and motor areas during task performance. The activation during single tasks was significantly weaker than during sequential and simultaneous dual-tasking. In the sequential dual-tasking, the mean functional connectivity during the walking-then-calculating task was significantly stronger (0.54±0.33) than during the calculation-then-walking task (0.38±0.15). The average gait speeds during single-task walking and during walking-then-calculation were 33.65±6.22cm/s and 32.21±8.84cm/s, respectively, significantly higher than during dual-tasking (24.37±10.33cm/s). Conclusions The task undertaken significantly affects cerebral activation patterns and walking performance after a stroke. Stroke survivors exhibit significantly greater activation in the prefrontal and motor cortices when performing sequential and simultaneous tasks compared to single tasks. Task difficulty and sequencing also significantly influence their gait. |
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