| 陈 金,敖丽娟,杨菲菲,李咏梅.计算机辅助上肢训练对脑卒中患者与正常人脑可塑性影响的功能磁共振成像对比研究[J].中国康复医学杂志,2013,28(11):990~995 |
| 计算机辅助上肢训练对脑卒中患者与正常人脑可塑性影响的功能磁共振成像对比研究 点此下载全文 |
| 陈 金 敖丽娟 杨菲菲 李咏梅 |
| 昆明医科大学第二附属医院康复医学科，昆明，650101 |
| 基金项目：云南省教育厅科学研究基金项目（07C10295） |
| DOI： |
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| 摘要： |
| 摘要
目的：探讨计算机辅助训练上肢对脑卒中患者与正常人脑可塑性的可能作用。
方法：对5名正常志愿者（对照组）及5例脑卒中上肢偏瘫患者（实验组）进行6周的计算机辅助训练，每周训练5次，在训练前、训练后分别在受试者屈伸左右腕关节时进行功能磁共振成像（fMRI）扫描，并对实验组进行Fulg-Meyer上肢功能评定（FMA），改良Barthel指数（MBI）量表评定。
结果：实验组与对照组相比，治疗前，运动左侧腕关节时，激活脑区主要在左额中央前回（同侧的感觉运动皮质区）；治疗后，运动左侧腕关节时，实验组与对照组相比，激活脑区在同侧感觉运动皮质区，但激活强度及体素均较治疗前有明显的降低。治疗前，运动右腕关节时，两者的激活脑区的部位相似，均在对侧的SMC区及同侧的小脑，但激活强度和体素较对照组小；治疗后，运动右腕关节时，两组之间无显著差异。
结论：计算机辅助训练可诱导出大脑皮质功能区的重组与代偿，使其趋向正常化。 |
| 关键词：缺血性脑卒中 计算机辅助训练 功能磁共振 康复 神经可塑性 |
| A functional magnetic resonance image comparative study of brain plasticity with computer-assisted upper extremity functional training in stroke patients and normal people Download Fulltext |
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| Dept. of Rehabilitation Medicine, The Second Affiliated Hospital of Kunming Medical University, Kunming,Yunnan,650101 |
| Fund Project: |
| Abstract: |
| Abstract
Objective: To investigate the effects of computer-assisted upper extremity functional training on cortical reorganization and associated motor recovery in stroke patients and normal people with functional magnetic resonance image(fMRI) technology.
Method: Computer-assisted upper extremity functional training was applied in 5 healthy people(control group) and 5 stroke of left hemiparesis(experimental group),5 times a week for 6 weeks. Pretreatment and posttreatment fMRI with 1.5T scanner was performed during the subjects attempted to do sequential wrist flexion-extension. Fulg-Meyer assessment-upper extremity(FMA-U) and modify Barthel index(MRI) were used for assessment.
Result: Comparing the experimental group with control group, during the subjects performed motor task with left wrist, the more activated regions appeared mainly in ipsilateral sensorimotor cortex (SMC) pretreatment, but the intensity and voxel of activated regions of ipsilateral SMC decreased evidently posttreatment. During the subjects performed motor task with right wrist, before training, on fMRI, the activated regions appeared in contralateral primary SMC and ipsilateral cerebellum, but the intensity and voxel of activated regions of ipsilateral were lower than control group; after training, there was no difference between two groups.
Conclusion: Computer-assisted upper extremity functional training can induce reorganization and compensation of cerebral cortex, and make them trending to normal. |
| Keywords:ischemic stroke computer-assisted training functional magnetic resonance imaging rehabilitation neuroplasticity |
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