基于功能性近红外光谱技术探索脑卒中后偏瘫患者不同踝关节牵伸训练任务与皮层活动的相关性

目的：通过功能性近红外光谱技术(fNIRS)初步探讨脑卒中后偏瘫患者在执行不同踝关节牵伸训练任务过程中大脑皮层感兴趣区域（ROIs）的激活差异及其相关性。方法：将26例脑卒中偏瘫患者分为2组：非优势半球组患者14例,优势半球组患者12例。病例入组时,首先对受试者进行临床功能评估,再运用fNIRS监测受试者在执行患侧踝关节牵伸训练任务过程中ROIs氧合血红蛋白(oxy-Hb)的浓度变化。结果：主动踝关节背屈与跖屈训练任务的脑区激活程度高于被动踝关节背屈与跖屈训练及静息状态（P<0.05）,而踝关节被动牵伸训练任务的脑区激活程度高于静息状态（P<0.05）。另外,优势半球组患者受累侧ROIs激活整体上高于非受累侧,且大脑半球偏侧化指数（LI）数值大于0的可能性大。非优势半球组患者在执行患侧踝关节牵伸训练任务时,感觉运动皮层（SMC）的激活程度与6min步行试验（6MWT）的步行距离成正相关（r=0.5531~0.6165,P<0.05）。结论：脑卒中后偏瘫患者踝关节不同牵伸训练任务与皮层活动存在一定的差异及相关性。

Correlation between different stretching training tasks of ankle joint and brain cortical activation in post-stroke patients with hemiplegia base on fNIRS

Objective: To investigate the differences in the regions of interest (ROIs) related to different stretching training tasks of the ankle joint, and to identify the correlations between the tasks and the activation of ROIs in post-stroke patients with hemiplegia. Methods: In this study, 26 post-stroke patients with hemiplegia were recruited and divided into 2 groups: 14 cases of non-dominant hemispheric group and 12 cases of the dominant hemispheric group. Each participant received several clinical functional assessments before the experiment. A multichannel fNIRS system was used to monitor and record the oxyhemoglobin (oxy-Hb) in each cortical areas of interest during the experimental tasks. Results: The active dorsiflexion and plantar flexion training tasks of ankle joint had higher brain activation than passive ankle dorsiflexion and plantar flexion training and resting state (P<0.05), while passive training tasks had higher brain activation than resting state (P<0.05). On the whole, ROIs activation on the affected side was higher than that on the non-affected side in the dominant hemisphere. The lateralization index (LI) of the dominant hemisphere group was more likely to be greater than 0. In the non-dominant hemisphere group, there was a positive correlation between the activation of SMC associated with ankle training and 6MWT walking distance (r=0.5531-0.6165, P<0.05). Conclusion: There are some differences and correlations between different stretching training tasks of ankle joint and cortical activity in post-stroke patients with hemiplegia.