皮质下脑梗死患者初级运动皮质结构损伤和运动功能恢复的相关性研究

目的探讨脑梗死后结构损伤和功能代偿脑区的相关性,为阐述脑梗死后运动功能恢复的机制提供理论基础。方法选择运动功能恢复较好的慢性期单侧基底节区脑梗死患者28例(脑梗死组),健康体检者25例(对照组),功能MRI采用组块设计,进行患手虚握运动以及高分辨率结构像采集,采用统计参数图比较2组脑灰质体积和执行运动任务时脑激活的不同。结果与对照组比较,脑梗死组患侧半球M1区(感兴趣区1)及丘脑灰质体积减少。患手运动时,脑梗死组患侧半球M1区(感兴趣区2)及颞上回激活增强。感兴趣区1和感兴趣区2重叠,重叠区占灰质体积减少脑区(感兴趣区1)的21.9%。结论 M1结构损伤区及其周围正常脑区均参与运动功能的恢复,而与感觉功能有密切关系的M1区背侧的持续性激活增强可能对运动功能的恢复起更主要的作用。

Functional MRI for correlation between primary motor cortex structure and function in subcortical cerebral stroke patients

Objective To provide the theoretical evidence for the motor function recovery by studying the correlation between injured motor cortex structure and functional compensatory brain area after cerebral stroke.Methods Twenty-eight patients with chronic cerebral stroke at the basal ganglia area whose motor function was well recovered served as cerebral stroke group and 25 healthy subjects served as control group in this study.A functional MRI block was designed.High resolution images were collected.Differences in brain activation and gray matter volume of the two groups were compared according to the statistical parametric figures.Results The affected hemisphere M1 area(interested area 1) and thalamul gray matter volume were smaller in cerebral stroke group than in control group.The activation level of affected hemisphere M1 area(interested area 2) and superior temporal gyrus was higher in cerebral stroke group when the affected hand was in motion.The interested areas 1 and 2 were overlaped.The reduced gray matter volume in interested area 1 accounted for 21.9% of the overlapped area.Conclusion Injuried M1 structure and its surrounding normal brain regions are involved in motor function recovery.Persistent activation of the dorsal M1 which is closely related with sensory function may play a greater role in motor function recovery.