李晓寒,唐溧峰,顾梦笔,等.辣椒素口腔刺激对脑卒中后吞咽障碍患者大脑皮质血流动力学信号影响的功能性近红外光谱成像观察[J].中华物理医学与康复杂志,2025,47(10):906-913
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| 辣椒素口腔刺激对脑卒中后吞咽障碍患者大脑皮质血流动力学信号影响的功能性近红外光谱成像观察 |
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| DOI：10.3760/cma.j.cn421666-20250331-00281 |
| 中文关键词: 功能性近红外光谱成像技术 脑卒中 吞咽障碍 辣椒素 |
| 英文关键词: Functional near-infrared spectroscopy Stroke Dysphagia Capsaicin |
| 基金项目:宁波市公益性研究计划重点项目（2024S036）；浙江省病理生理学技术研究重点实验室开放基金（202307）；宁波市康复医院院级重点项目（2024KY01） |
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| 中文摘要: |
| 目的 本研究采用功能性近红外光谱成像（fNIRS）技术探讨辣椒素口腔刺激对脑卒中后吞咽障碍（PSD）患者大脑皮质血流动力学信号的影响。 方法 选取34例PSD患者，分别接受生理盐水和辣椒素溶液的口腔刺激，记录其大脑皮质氧合血红蛋白（HbO）浓度变化，并分析皮质激活水平、功能连接及半球偏侧化特征。 结果 （1）辣椒素口腔刺激能显著提高PSD患者前额叶及运动区的HbO浓度，其激活程度高于生理盐水口腔刺激及静息状态时相应水平（P＜0.05）；（2）生理盐水和辣椒素口腔刺激均能增强PSD患者全脑功能连接强度，并以辣椒素口腔刺激时双侧前额叶与右侧运动区间的功能连接增强幅度尤为显著（P＜0.05）；（3）生理盐水和辣椒素口腔刺激均能诱导PSD患者全脑及前额叶皮质右侧半球偏侧化改变，而运动皮质则维持左偏侧化特征，并且以辣椒素刺激时的偏侧化指数显著高于生理盐水刺激时相应水平（P＜0.05）。 结论 与静息状态及生理盐水刺激时比较，辣椒素口腔刺激可显著增强PSD患者大脑皮质激活水平，提高前额叶-运动皮质间的功能连接强度，并促进大脑偏侧化模式调整。 |
| 英文摘要: |
| Objective To investigate the effect of oral capsaicin stimulation on the cerebral cortex hemodynamics of patients with post-stroke dysphagia (PSD). Methods Thirty-four PSD patients were subjected to oral stimulation with either a saline or a capsaicin solution. Functional near-infrared spectroscopy (fNIRS) was used to document any changes in cortical oxyhemoglobin (HbO) concentrations and cortical activation. Functional connectivity (FC) and hemispheric lateralization were analyzed. Results (1) Capsaicin stimulation significantly increased HbO concentration in the prefrontal and motor areas, producing significantly greater activation than saline stimulation and the resting state. (2) Both saline and capsaicin oral stimulation enhanced whole brain FC, with capsaicin producing a more pronounced increase between the bilateral prefrontal cortex and the right motor cortex. (3) Both saline and capsaicin stimulation induced a right-hemispheric lateralization trend in the whole brain and the prefrontal cortex, while the motor cortex maintained a left-lateralization pattern. Notably, the lateralization index under capsaicin oral stimulation was significantly higher than that under saline oral stimulation. Conclusions Compared with the resting state and saline stimulation, capsaicin oral stimulation significantly enhances cortical activation above the resting state, and significantly more than saline stimulation. It increases FC between the prefrontal and motor cortices, and promotes adjustments in brain lateralization patterns in persons with PSD. |
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