脑卒中患者大幅度运动状态下的大脑网络拓扑属性研究
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摘要
目的:分析有利于表征运动功能强弱的网络参数,为客观评价脑卒中患者的运动功能恢复提供参考。方法:应用fNIRS采集7例右脑卒中患者在指鼻运动过程中的大脑血红蛋白信息,然后进行功能网络建立,分析患者随着运动功能的恢复网络拓扑属性的变化规律。结果:(1)脑功能网络的连接数在患病40天左右呈下降趋势,之后呈上升趋势;(2)主运动皮质(M1)的连接数在患病初期明显减少,后期相应的聚类系数变大;(3)前期SMA、PMC等局部区域聚类系数随患病天数逐渐增大,转折点之后又逐渐减小。结论:(1)脑功能网络参数有先减小后增大的趋势,转折点一般在40天左右,很可能与介入治疗及展开康复训练的时间有关;(2)脑功能区域尤其是M1区域的网络参数更有利于表征运动功能的强弱;(3)SMA、PMC等区域在患病初期可能承担着代偿作用,后期代偿逐渐减弱。结合全局网络参数和局部参数的相对变化,有利于为客观评估运动能力提供参考依据。
Objective:To analyze the network parameters that characterize the strength of the motion function.Method:Use near-infrared spectroscopic topography to collect the cerebral hemoglobin information of 7 patients with right stroke during the process of finger to nose movement, then build functional network and analyze the relationship between the network parameters and the number of days after getting sick as well as the movement function strength.Result:(1)Data of brain function network connections in patients showed a downward trend for about 40 days after they got sick, and then showed the upward trend.(2)The number of connections in the primary motor cortex(M1) was significantly reduced at the beginning of the disease, and the corresponding clustering coefficient increased at the later stage of stroke.(3)The clustering coefficient of SMA, PMC and other local areas increased gradually with the number of sick days, and then gradually decreased after the turning point.Conclusion:(1)Brain function network parameters gradually decrease for about 40 days after getting sick, and then gradually increase. The turning point is likely to be related to the time of interventional therapy and rehabilitation training.(2)The brain function area, especially the M1 region of the network parameters is more condu-cive to characterize the strength of motor function.(3)SMA, PMC and other regions in the early stages of illness may bear the compensatory effect, later compensatory gradually weakened. It is beneficial to take the changes of global and local parameters into consideration while assessing the rehabilitation.
Objective:To analyze the network parameters that characterize the strength of the motion function.Method:Use near-infrared spectroscopic topography to collect the cerebral hemoglobin information of 7 patients with right stroke during the process of finger to nose movement, then build functional network and analyze the relationship between the network parameters and the number of days after getting sick as well as the movement function strength.Result:(1)Data of brain function network connections in patients showed a downward trend for about 40 days after they got sick, and then showed the upward trend.(2)The number of connections in the primary motor cortex(M1) was significantly reduced at the beginning of the disease, and the corresponding clustering coefficient increased at the later stage of stroke.(3)The clustering coefficient of SMA, PMC and other local areas increased gradually with the number of sick days, and then gradually decreased after the turning point.Conclusion:(1)Brain function network parameters gradually decrease for about 40 days after getting sick, and then gradually increase. The turning point is likely to be related to the time of interventional therapy and rehabilitation training.(2)The brain function area, especially the M1 region of the network parameters is more condu-cive to characterize the strength of motor function.(3)SMA, PMC and other regions in the early stages of illness may bear the compensatory effect, later compensatory gradually weakened. It is beneficial to take the changes of global and local parameters into consideration while assessing the rehabilitation.
引文
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[17]Newton J,Sunderland A,Butterworth SE,et al.A pilot study of event-related functional magnetic resonance imaging of monitored wrist movements in patients with partial recovery[J].Stroke,2002,33:2881-288.
[18]廖翔.高频重复经颅磁刺激治疗缺血性脑卒中后运动功能障碍机制的功能磁共振成像研究[D].四川,川北医学院,2016.
[19]石海杉.超低频经颅磁刺激对局部脑缺血再灌注损伤大鼠海马区内源性神经干细胞的影响[D].广州,南方医科大学,2015.
[20]席友缘.多模式手部运动想象下的经颅磁刺激运动诱发电位研究[D].天津,天津大学,2011.
[21]赵鑫.基于生物电信号的上肢康复机器人的研究[D].天津,天津理工大学,2016.
[22]孟亮亮,徐大伟,张敬.脑梗死后运动功能恢复机制的功能MRI研究进展[J].中华放射学杂志,2015,49(9):718-720.
[2]孙俊峰.复杂脑网络研究进展-结构、功能、计算与应用[J].复杂系统与复杂性科学,2010,7(4):74-90.
[3]周俊,白净.近红外光谱技术及其在脑功能成像中的应用[J].国外医学·生物医学工程分册,2000,23(4):193-197.
[4]Li C,Chen T,Qu W,et al.Identification of motion trend of lower limbs based on Near-infrared Spectroscopic Technology[J].Adv Mech,2015,7(3):1-8.
[5]Marshall RS,Perera GM,Lazar RM,et al.Evolution of cortical activation during recovery from corticospinal tract infarction[J].Stroke,2000,31(3):656-661.
[6]Carey JR,Kimberley TJ,Lewis SM,et al.Analysis of fM-RI and finger tracking training in subjects with chronic stroke[J].Brain,2002,125(4):773-788.
[7]Kato H,Izumiyama M,Koizumi H,et al.Near-infrared spectroscopic topography as a tool to monitor motor reorganization after hemiparetic stroke:a comparison with functional MRI[J].Stroke,2002,33(8):2032-2036.
[8]Torrence C,Compo GP.A practical guide to Morlet wavelet analysis[J].BAMS,1998,79(1):61-78.
[9]Li Z,Leung JY,Tam EW,et al.Wavelet analysis of skin blood oscillations in persons with spinal cord injury and able-bodied subjects[J].Arch Phys Med Rehab,2006,87:1207-1212.
[10]Aaslid R,Markwalder TM,Nornes H.Noninvasive transcranial Doppler ultrasound recording of flow velocity in basal cerebralarteries[J].J Neurosurg,1982,57(6):769-774.
[11]薛绍伟,唐一源,李健.一种基于f MRI数据的脑功能网络构建方法[J].计算机应用研究,2010,27(11):4055-4057.
[12]Rehme AK,Fink GR,von Cramon DY,et al.The role of the contralesional motor cortex for motor recovery in the early days after stroke assessed with longitudinal FMRI[J]Cerebral Cortex,2011,21(4):756-768.
[13]Wang L,Yu C,Chen H,et al.Dynamic functional reorganization of the motor execution network after stroke[J].Brain2010,133(4):1224-1238.
[14]许惠娟.双侧大脑半球间功能连接与脑卒中运动康复[D].天津:天津医科大学,2015.
[15]Dimyan MA,Cohen LG.Contribution of transcranial magnetic stimulation to the understanding of functional recovery mechanisms after stroke[J].Neurorehabil Neural Repair2010,24(2):125-135.
[16]Calautti C,Baron JC.Functional neuroimaging studies of motor recovery after stroke in adults:a review[J].Stroke,2003,34:1553-1566.
[17]Newton J,Sunderland A,Butterworth SE,et al.A pilot study of event-related functional magnetic resonance imaging of monitored wrist movements in patients with partial recovery[J].Stroke,2002,33:2881-288.
[18]廖翔.高频重复经颅磁刺激治疗缺血性脑卒中后运动功能障碍机制的功能磁共振成像研究[D].四川,川北医学院,2016.
[19]石海杉.超低频经颅磁刺激对局部脑缺血再灌注损伤大鼠海马区内源性神经干细胞的影响[D].广州,南方医科大学,2015.
[20]席友缘.多模式手部运动想象下的经颅磁刺激运动诱发电位研究[D].天津,天津大学,2011.
[21]赵鑫.基于生物电信号的上肢康复机器人的研究[D].天津,天津理工大学,2016.
[22]孟亮亮,徐大伟,张敬.脑梗死后运动功能恢复机制的功能MRI研究进展[J].中华放射学杂志,2015,49(9):718-720.