皮层下脑卒中患者两种康复治疗的功能磁共振研究

目的:通过功能磁共振探讨两种康复治疗皮层下脑卒中患者的疗效及潜在机制。方法:患者随机分为强制性运动疗法(constraint-induced movement therapy,CI MT)与神经发育疗法(neurodevelopmental treat ment,NDT)两个治疗组。在康复治疗前、后行血氧水平依赖功能磁共振成像(blood oxy-genationlevel dependent functional magnetic resonance imaging,BOLD-f MRI),并进行临床评分。结果:在康复治疗前、后,健手运动的激活模式近于正常人。患手运动时,运动区广泛激活;治疗后双侧大脑半球激活的体素数显著减少,并向正常激活模式集中。治疗前、后的临床评分显示CI MT组康复效果优于NDT组。结论:康复治疗能促进脑功能重组;CI MT对皮层下脑卒中后3~9个月患者的康复效果优于NDT。

A BOLD-fMRI study in motor recovery after subcortical stroke

Objective：To explore effect and possible mechanism of two rehalibitation treatment for patients with subcortical stroke by BOLD-fMRI.Methods：A total of 10 cases with subcortical stroke were randomly divided into two groups：constraint-induced movement therapy（CIMT）group and neurodevelopmental treatment（NDT）group.Blood oxygenation level dependent functional magnetic resonance imaging（BOLD-fMRI）was employed before and after treatment,and clinical evaluation was carried out.Results：Activation mode of healthy hand was similar to healthy person＇s.The motor area showd extensive activation as the ill hands moving.After treatment,the amount of activated voxel in bilateral cerebral hemisphere declined and was prone to normal activation mode.The evaluation showed more effective result in CIMT group.Conclusions：Rehabilitative treatment can promote cerebral functional reorganization.And CIMT is more effective than NDT in treating patients with subcortical stroke 3 to 9 months after stroke.