The plasticity of intrinsic functional connectivity patterns associated with rehabilitation intervention in chronic stroke patients
The plasticity of intrinsic functional connectivity patterns associated with rehabilitation intervention in chronic stroke patients
复制标题
慢性中风患者康复干预相关的内在功能连接模式的可塑性
DOI：
10.1007/s00234-016-1647-4
复制
发表时间：
2016
期刊：
影响因子：
2.8
通讯作者：
Fan Mingxia
中科院分区：
文献类型：
--
作者：
Zheng Xiaohui;Sun Limin;Yin Dazhi;Jia Jie;Zhao Zhiyong;Jiang Yuwei;Wang Xiangmin;Wu Jie;Gong Jiayu;Fan Mingxia
简介已经证明康复干预可以促进中风患者运动功能的恢复。然而，人们对康复治疗背后的神经机制知之甚少。本研究的目的是探讨慢性脑卒中患者与康复干预相关的内在功能连接模式的可塑性。方法12例左侧运动通路皮层下病变的慢性脑卒中患者参加为期4周的康复干预，并在干预前后接受静息态功能磁共振成像（fMRI）扫描。对脑卒中患者和健康对照者（HC）进行同侧（左）初级运动皮层（M1）的功能连接分析和连接模式偏侧化指数的测量。结果与HC相比，同侧M1与对侧感觉运动皮层（SMC）、双侧辅助运动区和顶下小叶因中风而降低的连接性在干预后显着恢复。更具体地说，双侧SMC的偏侧化指数趋于正常水平。此外，与干预前相比，我们观察到同侧 M1 与对侧 M1 和内侧额上回 (mSFG) 的连通性显着增加。此外，干预前与对侧 mSFG 的连接指数与运动改善呈正相关。 结论 康复干预对整个大脑内在功能连接模式的影响可以通过静息态功能磁共振成像来测量，静息态功能连接的系统评估可以为以后的运动改善提供预后洞察。
IntroductionIt has been demonstrated that rehabilitative interventions can promote motor function recovery in stroke patients. However, little is known regarding the neural mechanisms that underlie the rehabilitation treatments. The aim of this study was to investigate the plasticity of intrinsic functional connectivity patterns that are associated with rehabilitation intervention in chronic stroke patients.MethodsTwelve chronic stroke patients with subcortical lesions in the left motor pathway participated in a 4-week rehabilitation intervention and underwent resting-state functional magnetic resonance imaging (fMRI) scanning before and after the intervention. Both functional connectivity analyses of the ipsilesional (left) primary motor cortex (M1) and measurements of the lateralization index of the connectivity patterns were performed in both the stroke patients and healthy controls (HC).ResultsCompared with the HC, the decreased connectivity of the ipsilesional M1 with the contralesional sensorimotor cortex (SMC), bilateral supplementary motor areas, and inferior parietal lobule due to stroke were remarkably restored after the intervention. More specifically, the lateralization index of the bilateral SMC tends to be the normal level. Moreover, comparing post- with pre-intervention, we observed significantly increased connectivity of ipsilesional M1 with the contralesional M1 and medial superior frontal gyrus (mSFG). Additionally, the index of pre-intervention connectivity with the contralesional mSFG was positively correlated with motor improvement.ConclusionThe impact of rehabilitation intervention on intrinsic functional connectivity patterns throughout the brain was measurable on resting-state fMRI, and systematic assessment of resting-state functional connectivity can provide prognostic insight for later motor improvement.