本文關(guān)鍵詞：基于多階段BOLD-fMRI數(shù)據(jù)的腦卒中康復(fù)期運(yùn)動(dòng)功能研究　出處：《上海交通大學(xué)》2015年碩士論文　論文類型：學(xué)位論文

  更多相關(guān)文章： 腦卒中 BOLD-fMRI 激活水平 多階段運(yùn)動(dòng)康復(fù)

【摘要】：腦卒中可能會(huì)對(duì)患者的運(yùn)動(dòng)功能造成傷害,患者的康復(fù)常伴隨著神經(jīng)網(wǎng)絡(luò)結(jié)構(gòu)和功能重塑�；谘跛揭蕾�(Blood oxygen level dependent,BOLD)的功能磁共振成像(Functional magnetic resonance imaging,fMRI)作為一種強(qiáng)有力的技術(shù)手段能夠?qū)Υ竽X活動(dòng)進(jìn)行高空間分辨率成像,已被廣泛地應(yīng)用于腦卒中康復(fù)過程中神經(jīng)功能研究。本研究基于任務(wù)相關(guān)的fMRI實(shí)驗(yàn),通過對(duì)腦卒中患者康復(fù)的長時(shí)程觀察來研究病人大腦功能的可塑性變化。我們采集到19個(gè)皮質(zhì)脊髓束受損的腦卒中病人在三個(gè)階段的BOLD-fMRI數(shù)據(jù),即急性期(2周以內(nèi)),恢復(fù)期(1~3個(gè)月)及恢復(fù)后期(大于3個(gè)月),其中包含11例僅基底節(jié)區(qū)域損傷的卒中病人。我們研究了被試在康復(fù)不同階段執(zhí)行健側(cè)手和患側(cè)手任務(wù)時(shí)腦功能活動(dòng)的變化,并提取了相關(guān)腦激活水平參數(shù),包括:激活體積、激活強(qiáng)度和加權(quán)的側(cè)邊性指數(shù)(Weighted lateral index,wLI)等,同時(shí),分析了這些參數(shù)與患者臨床行為學(xué)評(píng)分,Fugl-Meyer評(píng)分的相關(guān)性。得到以下結(jié)果:(1)皮質(zhì)脊髓束受損腦卒中患者:在急性期和恢復(fù)期,在被試患手運(yùn)動(dòng)時(shí),大腦活動(dòng)呈現(xiàn)雙側(cè)激活,但是到恢復(fù)后期,腦功能活動(dòng)逐漸向患側(cè)轉(zhuǎn)移。這種與康復(fù)相關(guān)的腦功能活動(dòng)偏側(cè)化現(xiàn)象可以解釋為健側(cè)對(duì)患側(cè)運(yùn)動(dòng)功能損傷的一種補(bǔ)償機(jī)制。做患側(cè)手運(yùn)動(dòng)時(shí),在急性期和恢復(fù)后期,主運(yùn)動(dòng)區(qū)以及恢復(fù)期的前運(yùn)動(dòng)區(qū)和丘腦的激活參數(shù)與Fugl-Meyer評(píng)分呈顯著的正相關(guān),M1的wLI與FuglMeyer評(píng)分呈顯著的正相關(guān),患側(cè)M1在急性期的激活強(qiáng)度與行為學(xué)評(píng)分有顯著相關(guān)性�；紓�(cè)的PM,健側(cè)的丘腦的激活強(qiáng)度和激活體積都與行為學(xué)評(píng)分在恢復(fù)期有顯著相關(guān)性;急性期患側(cè)M1的激活強(qiáng)度與恢復(fù)期評(píng)分有顯著相關(guān)性�；謴�(fù)期小腦的wLI、患側(cè)小腦的激活體積均與恢復(fù)后期和恢復(fù)期Fugl-Meyer評(píng)分之差有顯著的負(fù)相關(guān)性。在恢復(fù)期,雙側(cè)扣帶回的激活強(qiáng)度或激活體積都與恢復(fù)后期與恢復(fù)期評(píng)分之差有顯著正相關(guān)性。同時(shí),恢復(fù)期扣帶回的wLI與恢復(fù)后期的評(píng)分有顯著相關(guān)性。(2)病灶位于基底節(jié)區(qū)域的腦卒中患者:大腦激活分布與所有病人結(jié)果相似。在恢復(fù)期階段,當(dāng)被試執(zhí)行患側(cè)手運(yùn)動(dòng)任務(wù)時(shí),健側(cè)扣帶回的激活體積,患側(cè)丘腦的激活體積和激活強(qiáng)度都與Fugl-Meyer評(píng)分有顯著的相關(guān)性;小腦的wLI指數(shù)與Fugl-Meyer評(píng)分呈顯著負(fù)相關(guān);扣帶回恢復(fù)期的wLI與兩個(gè)時(shí)期Fugl-Meyer評(píng)分之差呈顯著正相關(guān)。這項(xiàng)實(shí)驗(yàn)結(jié)果體現(xiàn)出大腦上面的這些區(qū)域的活動(dòng)對(duì)腦卒中康復(fù)可能有預(yù)測(cè)功能。本文的結(jié)果可能表明,腦卒中后大腦對(duì)運(yùn)動(dòng)功能的控制會(huì)受到影響,健側(cè)腦在腦卒中后不同階段發(fā)揮不同程度的補(bǔ)償作用,導(dǎo)致大腦激活向健側(cè)轉(zhuǎn)移,激活強(qiáng)度、激活體積和wLI三個(gè)參數(shù)與FuglMeyer評(píng)分在不同階段具有顯著相關(guān)性,其結(jié)果具有潛在的臨床預(yù)測(cè)價(jià)值.
[Abstract]:Stroke may cause injury to the patient's motor function. Rehabilitation is often accompanied by neural network structure and functional remodeling. Blood oxygen level dependent is based on the level of blood oxygen. Bod) functional magnetic resonance imaging. As a powerful technique, fMRI can perform high spatial resolution imaging of brain activity. This study is based on task-related fMRI experiments. The plasticity of brain function in patients with stroke was studied by long-term observation of rehabilitation. We collected BOLD-fMRI data of 19 stroke patients with corticospinal tract damage at three stages. . That is, the acute stage is within 2 weeks, the recovery period is 1 ~ 3 months) and the later stage of recovery (more than 3 months). We studied the changes of brain function during the different stages of rehabilitation of the healthy hand and the affected hand, and extracted the relevant brain activation level parameters. Including: activation volume, activation intensity and weighted lateral index (weighted lateral index), etc. The correlation between these parameters and the Fugl-Meyer score was analyzed. The following results were obtained: acute and convalescent in patients with corticospinal tract injury stroke. At the time of hand movement, brain activity showed bilateral activation, but at the late stage of recovery. Brain functional activity is gradually transferred to the affected side. This phenomenon of lateralization of brain function related to rehabilitation can be explained as a compensation mechanism for the damage of contralateral contralateral motor function. The activation parameters of the main motor area and the anterior motor area and thalamus were positively correlated with the Fugl-Meyer score in the acute stage and the late stage of recovery. There was a significant positive correlation between wLI and FuglMeyer score in M1, and there was a significant correlation between the activation intensity of M1 and behavioral score in the acute phase of the affected side, and PM in the affected side. The activation intensity and volume of the thalamus in the healthy side were significantly correlated with the behavioral score in the convalescent stage. The activation intensity of M1 in the acute stage was significantly correlated with the recovery score. WLI in the cerebellum of the convalescent stage. There was a significant negative correlation between the activation volume of the affected cerebellum and the Fugl-Meyer score in the later stage of recovery and the recovery stage. The activation intensity or volume of bilateral cingulate gyrus was positively correlated with the difference between recovery and recovery score. WLI of cingulate gyrus in convalescent stage was significantly correlated with the score at the later stage of recovery. 2) Stroke patients whose lesions were located in the basal ganglia region: the distribution of cerebral activation was similar to that of all patients. The activation volume of the contralateral cingulate gyrus and the activation volume and intensity of the affected thalamus were significantly correlated with the Fugl-Meyer score when the subjects performed the task of hand movement. The wLI index of cerebellum was negatively correlated with Fugl-Meyer score. There was a significant positive correlation between the difference between wLI and Fugl-Meyer scores in the recovery of cingulate gyrus. The results showed that the activities of these areas above the brain might predict the recovery of stroke. The results of this paper may indicate. The control of cerebral motor function will be affected after stroke. The contralateral brain plays a compensatory role in different stages after stroke, resulting in brain activation transfer to the healthy side and activation intensity. Activation volume and wLI were significantly correlated with FuglMeyer scores at different stages, and the results had potential clinical predictive value.
【學(xué)位授予單位】：上海交通大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2015
【分類號(hào)】：R743.3

【共引文獻(xiàn)】

相關(guān)期刊論文 前10條

1 張寶林;張輝陽;;超順磁性氧化鐵納米粒子在腦磁共振成像中的應(yīng)用[J];磁共振成像;2011年05期

2 王超;杜劍平;閆鑌;王大會(huì);史大鵬;;SPM軟件包頭動(dòng)校正原理的分析與評(píng)價(jià)[J];中國組織工程研究與臨床康復(fù);2010年52期

3 王浩;郭冰冰;陳麗峰;侯文生;陰正勤;;視覺正常人簡單圖形視覺刺激的視皮層功能定位及定量研究[J];眼科新進(jìn)展;2010年01期

4 邱文娟;李建新;閆鑌;杜劍平;史大鵬;;基于SPM5的視覺刺激3T功能磁共振成像數(shù)據(jù)處理研究[J];信息工程大學(xué)學(xué)報(bào);2010年03期

5 許守林;郭萬華;張劍戈;賈鵬;李愛梅;;PET標(biāo)準(zhǔn)腦圖譜在阿爾茨海默病早期診斷中的應(yīng)用[J];中國醫(yī)療設(shè)備;2009年10期

6 支聯(lián)合;譚素敏;杜遠(yuǎn)東;;磁共振成像技術(shù)的物理學(xué)原理[J];周口師范學(xué)院學(xué)報(bào);2008年02期

7 張艷;陳春曉;張志強(qiáng);盧光明;;基于代價(jià)函數(shù)掩模法的局部腦損傷fMRI數(shù)據(jù)處理[J];中國生物醫(yī)學(xué)工程學(xué)報(bào);2008年06期

8 郝冬梅;李瑩;李明愛;;基于功能磁共振成像的大腦運(yùn)動(dòng)皮層網(wǎng)絡(luò)連通性研究[J];中國生物醫(yī)學(xué)工程學(xué)報(bào);2009年03期

9 支聯(lián)合;王華東;張潔;;統(tǒng)計(jì)參數(shù)圖和多尺度特征提取用于事件相關(guān)fMRI分析的比較[J];中國生物醫(yī)學(xué)工程學(xué)報(bào);2011年01期

10 支聯(lián)合;譚素敏;楊建國;;基于混頻去除和矩陣算法的多尺度特征提取方法分析fMRI數(shù)據(jù)[J];中國生物醫(yī)學(xué)工程學(xué)報(bào);2012年03期

相關(guān)博士學(xué)位論文 前10條

1 朱雪玲;首發(fā)未服藥青年重性抑郁癥腦網(wǎng)絡(luò)連接的磁共振成像研究[D];中南大學(xué);2011年

2 翁曉光;靜息態(tài)腦功能磁共振數(shù)據(jù)分析方法及在弱視神經(jīng)機(jī)制中的應(yīng)用研究[D];南京航空航天大學(xué);2010年

3 柯銘;基于功能磁共振成像的腦功能網(wǎng)絡(luò)模式研究與應(yīng)用[D];蘭州理工大學(xué);2009年

4 羅英姿;冗思在青少年抑郁發(fā)展中的作用及其神經(jīng)機(jī)制[D];中南大學(xué);2009年

5 李貞晶;基于腦功能區(qū)fMRI分析的針刺效應(yīng)研究[D];黑龍江中醫(yī)藥大學(xué);2012年

6 孫金燕;利用腦電及光電聯(lián)合檢測(cè)分別研究注意中的定向和執(zhí)行控制[D];華中科技大學(xué);2013年

7 陳俊琦;針刺缺血性腦卒中病人外關(guān)穴fMRI腦功能成像研究[D];南方醫(yī)科大學(xué);2013年

8 李永欣;珠心算訓(xùn)練對(duì)兒童大腦可塑性的影響以及大腦結(jié)構(gòu)隨訓(xùn)練時(shí)間的變化[D];浙江大學(xué);2013年

9 孫金燕;利用腦電及光電聯(lián)合檢測(cè)分別研究注意中的定向和執(zhí)行控制[D];華中科技大學(xué);2013年

10 李寶娟;基于功能磁共振成像的腦連接分析[D];國防科學(xué)技術(shù)大學(xué);2012年

，

本文編號(hào)：1369418