| 张 静,孙思杰,王先斌,吴 霜.基于功能性近红外光谱技术的脑卒中后复合障碍患者脑网络及脑激活特征[J].中国康复医学杂志,2026,(8):1210~1219 |
| 基于功能性近红外光谱技术的脑卒中后复合障碍患者脑网络及脑激活特征 点此下载全文 |
| 张 静 孙思杰 王先斌 吴 霜 |
| 贵州医科大学附属医院康复医学科，贵州省贵阳市，550001 |
| 基金项目：国家自然科学基金地区科学基金项目（82260452，82060419）；贵州省科学技术基金项目(黔科合基础-ZK[2022]重点045） |
| DOI：10.3969/j.issn.1001-1242.2026.08.004 |
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| 摘要： |
| 摘要
目的：比较健康人与脑卒中患者脑功能差异，探讨脑卒中后复合障碍患者脑网络及脑激活特征。
方法：纳入2023年12月—2024年6月在贵州医科大学附属医院康复科住院的脑卒中后上肢运动障碍患者22例作为单障碍组，脑卒中后上肢运动合并认知障碍患者23例作为复合障碍组，招募22例健康中老年人作为健康组，对3组受试者进行功能性近红外光谱技术（functional near-infrared spectroscopy， fNIRS）评估，比较静息态下脑功能连接差异，抓握任务态下左侧前额叶皮层（left prefrontal cortical， LPFC）、右侧前额叶皮层（right prefrontal cortical， RPFC）、左侧初级运动皮层（left primary motor cortex， LM1）、右侧初级运动皮层（right primary motor cortex， RM1）、左侧辅助运动皮层（left supplementary motor area， LSMA）、右侧辅助运动皮层（right supplementary motor area， RSMA）、左侧枕叶（left occipital lobe， LOL）、右侧枕叶（right occipital lobe，ROL）、左侧体感皮层（left somatosensory cortex， LS1），右侧体感皮层（right somatosensory cortex， RS1）的含氧血红蛋白浓度。
结果：与健康组相比，复合障碍组静息态下总体功能连接强度下降（P＜0.05），多个脑区间功能连接下降（P＜0.05），任务态下的整体脑激活均下降，其中LM1、LS1、LSMA的激活程度明显下降（P＜0.05）。健康组与单障碍组之间脑区激活无显著性差异。与单障碍组相比，复合障碍组RPFC、LM1、LPFC、LS1激活程度明显下降（P＜0.05），复合障碍组的LPFC-RM1、LPFC-RSMA、LOL-LPFC 、LOL-RS1 、ROL-RPFC 、ROL-LPFC、ROL-LSMA、ROL-RS1、RPFC-RM1、RPFC-LPFC、RPFC-RSMA、LPFC-LSMA、LPFC-RS1、RM1-RSMA、LSMA-RS1、RSMA-RS1、RPFC-RPFC功能连接强度明显下降（P＜0.05）。复合障碍患者的LPFC的脑区激活程度与MoCA、MMSE评分之间呈正相关，LSMA、RSMA脑区激活程度与临床评分FMA-UE之间呈正相关。
结论：脑卒中后复合障碍患者存在运动、认知相关脑区的激活明显受限及脑区间信息交流传输能力明显下降，主要表现为PFC、SMA、M1的血氧浓度及功能连接下降。 |
| 关键词：脑卒中 功能连接 脑网络 功能性近红外光谱技术 氧合血红蛋白 |
| Brain network and brain activation characteristics in patients with composite impairment after stroke based on fNIRS technique Download Fulltext |
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| Department of Rehabilitation Medicine， Affiliated Hospital of Guizhou Medical University， Guiyang， Guizhou， 550001 |
| Fund Project: |
| Abstract: |
| Abstract
Objective： To investigate differences in brain function between healthy individuals and stroke patients, and to examine the characteristics of brain networks and activation patterns in patients experiencing post-stroke composite impairment.
Method： Twenty-two patients with post-stroke upper limb motor impairment，who were hospitalized in the Department of Rehabilitation at the Affiliated Hospital of Guizhou Medical University from December 2023 to June 2024， were included as the single-impairment group. Additionally， 23 patients with post-stroke upper limb motor impairment combined with cognitive deficits were included in the composite impairment group. Furthermore， 22 healthy middle-aged and elderly individuals were recruited as the healthy control group. All participants across these three groups were assessed using functional near-infrared spectroscopy （fNIRS）. We compared differences in functional brain connectivity during resting state and measured oxygenated hemoglobin concentrations in both hemispheres of the prefrontal cortex （PFC）， primary motor cortex （M1）， supplementary motor cortex （SMA）， occipital lobe （OL）， and somatosensory cortex （S1） during a grasping task.
Result： Compared to the healthy group， the composite disorder group showed decreased overall functional connectivity strength in the resting state （P<0.05）， decreased functional connectivity between multiple brain regions （P<0.05） overall brain activation in both task states， with significant decreases in LM1， LS1， LSMA， and activation （P<0.05）. There was no statistically significant difference in brain area activation between the healthy group and the single-impairment group. Compared with the single-disorder group， the activation of RPFC， LM1， LPFC， and LS1 in the compound-disorder group was significantly decreased（P<0.05）. In the compound-disorder group， the activation of LPFC-RM1， LPFC-RSMA， LOL-LPFC， LOL-RS1， ROL-RPFC， ROL-LPFC， ROL-LSMA， ROL- RS1， RPFC-RM1， RPFC-LPFC， RPFC-RSMA， LPFC-LSMA， LPFC-RS1， RM1-RSMA， LSMA-RS1， RSMA-RS1， and RPFC-RPFC functional connectivity strengths were significantly reduced （P<0.05）. There was a positive correlation between the degree of activation of the brain regions of the LPFC and the MoCA and MMSE scores， and between the degree of activation of the brain regions of the LSMA and RSMA and the clinical scores FMA-UE in patients with complex disorders.
Conclusion： Patients with post-stroke complex disorders exhibit from markedly restricted activation of motor and cognition-related brain regions and markedly reduced ability to transmit information exchange between brain regions， which is mainly manifested in decreased blood oxygen concentration and functional connectivity of PFC， SMA， and M1. |
| Keywords:stroke functional connectivity brain network functional near-infrared spectroscopy oxyhemoglobin |
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