脑缺血性卒中患者运动功能康复的功能性磁共振成像研究

目的利用功能性磁共振成像（fMRI）技术研究急性期缺血性脑卒中患者（以下简称急性期患者）运动相关皮质的激活情况，并探讨脑卒中后脑功能重组特点及其与肢体运动功能恢复的关系。方法采用GEI．5T双梯度16通道磁共振成像系统，对9例急性期患者和9例健康志愿者行Bold—fMRI检查。fMRI检查以被动对指运动（以下简称运动）为刺激任务，所有数据采用SPM2软件包进行离线后处理。比较健康志愿者与急性期患者fMRI结果的异同点，计算脑激活区体积和单侧化指数（LI），考察急性期患者患手运动LI值与患手运动功能的关系。结果健康志愿者单手运动激活对侧感觉运动皮质（SMC）、双侧辅助运动区（SMA）。急性期患者患手运动时同侧半球脑激话增多，健手运动的fMRI结果与健康志愿者基本一致。LI值也进一步确定，急性期患者患手运动时同侧半球脑激活增多。统计学分析表明，急性期患者患手运动的LI值与患手运动功能呈正相关。结论fMRI检查能客观地反映急性期患者运动相关皮质改变，提示存在脑功能代偿与重组。急性期患者患手运动LI值与患手运动功能呈正相关，提示fMRI是研究缺血性脑卒中后肢体运动功能康复与脑功能重组之间关系的一种有效工具。

The effects of functional magnetic resonance imaging on motor cortex function in patients with cerebral ischemic stroke

Objective To investigate the effects of functional magnetic resonance imaging (fMRI)with acute ischemic stroke (AIS) patients,and to evaluate the relationship between brain reorganization and motor recovery.Methods Nine AIS patients and 9 healthy volunteers were assessed by fMR1 during passive finger clenching at a pace of 1 Hz.The fMRI results were analyzed using SPM2 software.Lateral indices (LIs) and activated regions were calculated,and the relationship between LI and muscle strength was examined.Results In the control group,activation was observed in the contralateral sensorimotor cortex (SMC) and the bilateral supplementary area (SMA) during the passive movement.In the AIS group,similar results were recorded dur- ing unaffected hand movement,but the ipsilateral activation areas were greater than those on the eontralateral side during movement of the affected hand.LI results confirmed that movement of the affected hand mainly elici- ted activation in the ipsilateral hemisphere.Conclusion The different fMRI manifestations of patients and nor- mal subjects reflect brain compensation,and fMRI is valuable for studying the correlation between motor function and brain reorganization.