本文選題：功能性近紅外腦成像　切入點：皮層功能重組　出處：《清華大學》2015年博士論文　論文類型：學位論文

【摘要】：功能性近紅外腦成像(functional near-infrared spectroscopy,fNIRS)是一種無創(chuàng)性光學腦功能成像技術,可檢測腦皮層中的氧合血紅蛋白(oxygenated hemoglobin,Oxy-Hb)和脫氧血紅蛋白(deoxygenated hemoglobin,Deoxy-Hb)濃度的變化。fNIRS具有檢測環(huán)境接近生活環(huán)境、對運動偽跡不敏感、時間分辨率較高等優(yōu)點,其缺點是空間分辨率差,但fNIRS與T1加權核磁共振結構像數據結合后可明顯提高空間定位準確性。目前,fNIRS對功能區(qū)腦占位性病變患者的運動皮層的功能檢測與功能磁共振成像(functional magnetic resonance imaging,fMRI)空間定位一致性尚不清楚,使用功能影像技術對腦腫瘤患者的運動皮層激活及可塑性進行研究對患者的治療具有重要意義。為了檢測fNIRS與fMRI對中央區(qū)腦占位病變的運動皮層激活的空間定位的一致性,本論文使用fNIRS對中央區(qū)腦占位性病變患者的雙側額頂葉區(qū)域的氧合反應進行了檢測,分別依據Oxy-Hb和Deoxy-Hb的變化生成激活圖。將fNIRS的結果與任務態(tài)fMRI的結果進行比較。結果表明,當患者進行腫瘤對側手抓握運動時,使用fNIRS和fMRI在腫瘤側初級感覺運動皮層(primary sensorimotor cortex,PSMC)、腫瘤對側PSMC檢測到的激活概率相當;Oxy-Hb與fMRI在運動皮層激活反應的一致性較Deoxy-Hb高;Oxy-Hb僅在2例患者未發(fā)現補充運動區(qū)(supplementary motor area,SMA)激活。為了研究中央區(qū)腦腫瘤患者PSMC激活及皮層功能重組狀況,本論文使用fNIRS對納入的17例中央區(qū)腦腫瘤患者和9例志愿者的雙側額頂葉區(qū)域進行檢測,采用腫瘤對側手部抓握任務,對PSMC的Oxy-Hb進行比較并計算偏側指數。結果發(fā)現,對照組激活最強的部位位于對側PSMC,患者組雖然在組分析上腫瘤側Oxy-Hb顯著高于非腫瘤側,但腫瘤側PSMC激活變異較大,從偏側性減弱甚至到偏側性逆轉�；颊呓MPSMC偏側指數顯著低于對照組。PSMC偏側指數與患手Fugl-Meyer指數正相關,即患手功能越差其PSMC的偏側性越趨向于健側。本研究得出如下結論:Oxy-Hb與fMRI對PSMC的激活反應的檢測結果一致性高。Oxy-Hb在少數患者未能檢測出與fMRI一致的SMA激活,可能與SMA的部分解剖位置較為深在有關。中央區(qū)腦腫瘤患者在進行腫瘤對側手部運動時,腫瘤側PSMA激活減弱,腫瘤側PSMC激活偏側性向健側偏移,PSMC的偏側性改變程度與腫瘤對側手部功能受損的程度有關。
[Abstract]:Functional near infrared brain imaging (FNIR) is a noninvasive optical imaging technique for the detection of oxygenated hemoglobulin (Oxy-Hb) and deoxyhemoglobulin (Deoxy-Hb) concentrations in the cortex. FNIRS has the ability to detect changes in the concentrations of oxygenated hemoglobulin and deoxy-Hb in the cerebral cortex. FNIRS has the ability to detect environmental proximity to the living environment. It is insensitive to motion artifacts and has high time resolution, but its disadvantages are poor spatial resolution. However, the accuracy of spatial localization can be improved by combining fNIRS with T1-weighted MRI data. At present, FNIRS is used to detect the function of motor cortex and functional magnetic resonance imagingfMRI space in patients with brain occupying lesions in the functional area. Location consistency is not clear, It is important to study the activation and plasticity of motor cortex in patients with brain tumor by using functional imaging technique. In order to detect the consistency between fNIRS and fMRI in the spatial localization of motor cortex activation in central brain occupying lesions. In this study, fNIRS was used to detect the oxygenation response in bilateral frontal and parietal lobe regions in patients with central cerebral space-occupying lesions. Activation maps were generated according to the changes of Oxy-Hb and Deoxy-Hb, respectively. The results of fNIRS were compared with those of task-based fMRI. When the patient has a contralateral grip on the tumor, Using fNIRS and fMRI in the primary sensorimotor cortexes of the tumor side, the activation probability of the contralateral PSMC was similar. The consistency of the activation response between Oxy-Hb and fMRI in the motor cortex was higher than that in the Deoxy-Hb. Only in 2 patients did not the supplementary motor area be found. In order to study the activation of PSMC and the recombination of cortical function in patients with central brain tumor, In this study, fNIRS was used to detect the bilateral frontal and parietal lobe regions of 17 patients with brain tumors in the central region and 9 volunteers. The Oxy-Hb of PSMC was compared and the hemiplegia index was calculated by using the task of grasping the contralateral hand of the tumor. The most active site in the control group was located in the contralateral PSMC. Although the Oxy-Hb of the tumor side was significantly higher than that of the non-tumor side, the PSMC activation of the tumor side varied significantly in the patient group. The hemiplegic index of the patients was significantly lower than that of the control group. There was a positive correlation between the hemiplegia index and the Fugl-Meyer index of the affected hand. That is, the lower the function of the affected hand, the more the side of PSMC tends to be contralateral. In this study, it is concluded that there is a high consistency between the results of the detection of the activation of PSMC by fMRI and that of the reaction of fMRI to PSMC. Oxy-Hb can not detect SMA activation consistent with that of fMRI in a few patients. It is possible that some anatomical location of SMA is deeply related. The activation of PSMA in the tumor side of brain tumor patients is decreased when the tumor is on the contralateral hand motion. The degree of hemiplegic change of PSMC activated to the contralateral side of the tumor was related to the degree of impairment of the contralateral hand function of the tumor.
【學位授予單位】：清華大學
【學位級別】：博士
【學位授予年份】：2015
【分類號】：R739.4

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本文編號：1579042