邓小湘;蒋雯;王君;汤启宇;黄瑞旺;张玉梅;艾林;戴建平;

• 1:北京师范大学认知神经科学与学习国家重点实验室
• 2:首都医科大学附属北京天坛医院影像科
• 3:香港理工大学医疗科技及资讯学系
• 4:首都医科大学附属北京天坛医院神经内科

摘要(Abstract)：

目的利用静息态功能磁共振成像技术研究缺血性脑卒中患者康复治疗前后运动功能网络连接变化的特点。方法对2例符合亚急性缺血性脑卒中影像学诊断标准的患者在功能性电刺激康复治疗前后各进行一次静息态功能磁共振扫描,比较两次扫描的运动脑区功能连接的差异。结果康复后患者上肢运动功能改善;与康复治疗前相比,康复治疗后左侧和右侧的运动皮层功能连接均降低,左侧和右侧的运动皮层功能连接系数降低值与脑卒中患者上肢运动功能以及日常生活能力的改善程度相关。结论缺血性脑卒中患者上肢运动功能改善后,即康复后患侧脑区对健侧脑区依赖性减低,并且功能连接系数的降低与脑卒中患者上肢运动功能的改善相关。

关键词(KeyWords)： 缺血性脑卒中;磁共振成像,功能性;静息态;运动皮质;电刺激;康复

Abstract:

Keywords:

基金项目(Foundation): 国家自然科学基金(30770617);; 教育部留学回国人员科研启动基金项目(The Project-sponsored by SRF for ROCS,SEM)资助

作者(Authors): 邓小湘;蒋雯;王君;汤启宇;黄瑞旺;张玉梅;艾林;戴建平;

参考文献(References)：

• [1]Biswal B.Functional connectivity in the motor cortex of resting human brain using echo-planar MRI.MRM,1995,34(4):537-541.
• [2]Greicius MD,Krasnow B,Reiss AL,et al.Functional connectivity in the resting brain:a network analysis of the default mode hypothesis.Proc Natl Acad Sci USA,2003,100(1):253-258.
• [3]Zang YF,He Y,Zhu CZ,et al.Altered baseline brain activity in children with ADHD revealed by resting-state functional MRI.Brain Dev,2007,29(2):83-91.
• [4]Greicius MD,Srivastava G,Reiss AL,et al.Default mode network activity distinguishes Alzheimer's disease from healthy aging:evidence from functional MRI.Proc Natl Acad Sci USA,2004,101(13):4637-4642.
• [5]Lowe MJ,Beall EB,Sakaie KE,et al.Resting state sensorimotor functional connectivity in multiple sclerosis inversely correlates with transcallosal motor pathway transverse diffusivity.Hum Brain Mapp,2008,29(7):818-827.
• [6]陈俊,刘波,刘岘,等.功能磁共振成像评价帕金森患者静息状态下脑功能连接.中国医学影像技术,2009,25(6):989-992.Chen J,Liu B,Liu J,et al.Functional MRI investigation of brain functional connectivity in resting-state of Parkinson's disease patients.Chin J Med Imaging Technol,2009,25(6):989-992.
• [7]Dorothee P.A.Spontaneous low-frequency blood oxygenation level-dependent fluctuations and functional connectivity analysis of the‘resting’brain.Magnetic Resonance Imaging,2008(7),26:1055-1064.
• [8]Raichle ME,Macleod AM,Snyder AZ,et al.A default mode of brain function.PNAS,2001,98(2):676-682.
• [9]De Luca M,Beckmann CF,De Stefano N,et al.fMRI resting state networks define distinct modes of long-distance interactions in the human brain.NeuroImage,2006,29(4):1359-1367.
• [10]Xiong J,Lawrence MP,JiaHong G,et al.Interregional connectivity to primary motorcortex revealed using MRI resting state images.Human Brain Mapping,1999,8(2-3):151-156.
• [11]Raichle ME.A brief history of human brain mapping.Trends in Neurosciences,2009,32(2):118-126.
• [12]Kralj A,Acimovic R,Stanic U.Enhancement of hemiplegic patient rehabilitation by means of functional stimulation.Prosthetic Orthotics Int,1993,17(2):107-114.
• [13]Chan MKL,Tong RKY,Chung KYK.The application of functional electrical stimulation(FES)in occupational therapy for the rehabilitation of upper limb function of patients with stroke:A preliminary study.12th Annual Conference of the International FES Society,Philadelphia,USA,10-14Nov2007.
• [14]Peltier SJ,Noll DC.T2*dependence of low frequency functional connectivity.NeuroImage,2002,16(4):985-992.
• [15]Solodkin A,Hlustik P,Chen EE,et al.Fine modulation in network activation during motor execution and motor imagery.Cereb Cortex,2004,14(11):1246-1255.
• [16]Fransson P.Spontaneous low-Frequency BOLD signal fluctuations:An fMRI investigation of the resting-state default mode of brain function hypothesis.Human Brain Mapping,2005,26(1):15-29.
• [17]刘功禄,赵永波.神经及精神障碍性疾病静息态fMRI研究.中国神经精神疾病杂志,2009,35(9):571-573.Liu G,Zhao Y.The resting-state fMRI investigation of nervous and psychic disease.Chin J Nerv Ment Dis,2009,35(9):571-573.
• [18]He BJ,Snyder AZ,Vincent JL,et al.Breakdown of functional connectivity in frontoparietal networks underlies behavioral deficits in spatial neglect.Neuron,2007,53(6):905-918.
• [19]Grefkes C,Eickhoff SB,Nowak DA,et al.Dynamic intra-and interhemispheric interactions during unilateral and bilateral hand movements assessed with fMRI and DCM.NeuroImage,2008,41(4):1382-1394.
• [20]Uddin L,Mooshagian E,Zaidel E,et al.Residual functional connectivity in the split-brain revealed with resting-state functional MRI.Neuroreport,2008,19(7):703-709.
• [21]Honey C,Sporns O,Cammoun L,et al.Predicting human resting-state functional connectivity from structural connectivity.Proc Natl Acad Sci USA,2009,106(6):2035-2040.
• [22]Greicius M,Supekar K,Menon V,et al.Resting-state functional connectivity reflects structural connectivity in the default mode network.Cereb Cortex,2009,19(1):72-78.
• [23]Jessica SD,Michael DG.Greater than the sum of its part a review of studies combining structural connectivity and resting state functional connectivity.Brain Struct Funct,2009,2(13):525-533.