曹洋洋,唐晓康,郭倩玉,等.基于功能性近红外光谱成像技术探索痉挛性脑瘫患儿脑功能网络及与运动功能间的相关性[J].中华物理医学与康复杂志,2025,47(11):998-1004
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| 基于功能性近红外光谱成像技术探索痉挛性脑瘫患儿脑功能网络及与运动功能间的相关性 |
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| DOI：10.3760/cma.j.cn421666-20250623-00521 |
| 中文关键词: 痉挛性脑瘫 功能性近红外光谱成像技术 静息态 脑功能网络 运动功能 |
| 英文关键词: Spastic cerebral palsy Functional near-infrared spectroscopy Brain functional networks Motor functioning |
| 基金项目:河南省科技厅重点研发与推广专项（202102310359） |
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| 中文摘要: |
| 目的 应用功能性近红外光谱成像技术（fNIRS）探索痉挛性脑瘫（SCP）患儿在静息状态下的脑功能网络特征，并分析其与运动功能间的相关性。 方法 选取2023年3月至2024年9月期间在郑州大学第三附属医院儿童康复科就诊的36例SCP患儿纳入SCP组，同期招募34例年龄与之匹配的健康儿童纳入健康对照组（HC组）。采用fNIRS技术检测上述对象在静息状态时大脑皮质氧合血红蛋白（HbO）浓度变化。选取左前额叶皮质（LPFC）、右前额叶皮质（RPFC）、左运动皮质（LMC）及右运动皮质（RMC）作为感兴趣脑区（ROI），通过相位锁定值（PLV）评估各脑区间的功能连接强度，并应用图论方法分析脑功能网络的拓扑结构。采用粗大运动功能量表（GMFM）对入选对象运动功能进行评估。 结果 通过分析脑功能连接强度发现，SCP组患儿在静息状态下各脑区间的功能连接强度均低于HC组水平，特别是LPFC-RPFC、LPFC-RMC、RPFC-RMC及LMC-RMC间的PLVs均较HC组显著降低（P＜0.05）；通过分析脑网络拓扑结构发现，SCP组患儿的全局效率（GE）、聚类系数（CC）及网络密度（D）均显著低于HC组水平（P＜0.05），而特征路径长度（L）则较HC组显著增加（P＜0.05）；通过相关性分析发现，SCP组患儿在静息状态下LMC-RMC的PLVs与GMFM量表D区及E区评分均具有显著正相关性（r=0.496、0.579，P＜0.05），GE（r=0.587、0.642，P＜0.05）和CC（r=0.318、0.759，P＜0.05）与GMFM量表D区及E区评分亦具有显著正相关性。 结论 SCP患儿在静息状态下存在显著的脑功能网络异常，且这种脑功能网络异常与其运动功能障碍密切相关。 |
| 英文摘要: |
| Objective To explore the characteristics of the brain functional networks in children with spastic cerebral palsy (SCP) while at rest and to correlate them with motor functioning. Methods Thirty-six children with SCP were enrolled as the SCP group, while thirty-four age-matched healthy children were recruited as the control group (the HC group). Functional near-infrared spectroscopy was used to detect changes in the concentration of oxygenated hemoglobin in the children′s cerebral cortex while at rest. The left prefrontal cortex (LPFC), right prefrontal cortex (RPFC), left motor cortex (LMC), and right motor cortex (RMC) were selected as regions of interest. Phase locking values (PLVs) were used to evaluate the strength of functional connectivity (FC) among these brain regions, and graph theory methods were applied to analyze the topological properties of the brain networks. Motor functioning was assessed using the gross motor function measure (GMFM). Results The analyses of FC strength revealed that the SCP group had significantly weaker FC among all of the regions of interest while at rest compared to the HC group. Their PLVs for LPFC-RPFC, LPFC-RMC, RPFC-RMC and LMC-RMC connectivity were all significantly smaller. Graph theory analysis showed that the SCP group had significantly lower global efficiency (GE) and smaller clustering coefficients (CCs) and network density (D), while their characteristic path lengths were significantly longer. According to the correlation analysis, the PLVs for LMC-RMC connections in the SCP group were positively correlated with their scores on dimensions D and E of the GMFM (r=0.496 and r=0.579 respectively). GE (r=0.587 and r=0.642) and CC (r=0.318 and r=0.759) showed similar significant positive correlations with GMFM dimensions D and E. Conclusions At rest, the functional networks in the brains of children with SCP exhibit abnormalities closely associated with their motor dysfunction. |
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