Effects of pseudoexperience on the understanding of hemiplegic movements in physical therapists: An fMRI study.
Effects of pseudoexperience on the understanding of hemiplegic movements in physical therapists: An fMRI study.
复制标题
假体验对物理治疗师偏瘫运动理解的影响：一项功能磁共振成像研究。
DOI：
10.1016/j.nicl.2019.101845
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发表时间：
2019
期刊：
影响因子：
--
通讯作者：
Taira M
中科院分区：
文献类型：
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作者：
Watababe R;Katsuyama N;Nobuo U;Taira M
物理治疗师（PT）必须通过观察评估准确了解患者的身体和精神状态。为了对患者的运动进行全面的观察评估，PT可能需要使用他们自己的神经系统参与动作理解和心理理论，例如动作观察网络（AON）和右颞顶连接（rTPJ）。这两个系统都是由观察者对所观察到的运动的实际经验来调节的。尽管大多数PT没有神经功能障碍的身体经验，但他们常规检查卒中患者的偏瘫运动，因此认为他们获得了偏瘫的假经验。我们假设，患者对偏瘫的假性体验会调节与理解他人相关的神经系统，以详细理解与偏瘫相关的身体和精神状态。为了研究我们的假设，我们招募了19名PT和19名幼稚参与者（NP），在观看偏瘫（HHM）和非偏瘫（non-HHM）手部运动视频的同时进行功能性MRI（fMRI）测量皮质活动。参与者随后在MRI扫描仪外再次观看相同的视频，并通过问卷调查评估观察到的手部运动。与NP相比，PT在AON和rTPJ中显示出更大的激活，同时观察到HHM。心理生理学相互作用分析显示，当PT查看HHM时，rTPJ和AON之间的连接增加。行为分析进一步表明，PT更准确地评估与HHM的感觉状态比NP。这些发现表明，PT的伪经验调节AON和rTPJ，使他们能够更好地理解偏瘫相关的感觉状态。
Physical therapists (PTs) are required to obtain an accurate understanding of the physical and mental states of their patients through observational assessment. To perform comprehensive observational assessments of patients' movements, PTs likely need to engage their own neural systems involved in action understanding and theory of mind, such as the action observation network (AON) and the right temporoparietal junction (rTPJ). Both systems are modulated by the observer's actual experience with the observed movements. Although, most PTs do not have physical experience with neurological disabilities, they routinely examine hemiplegic movements in stroke patients, and are thus considered to have acquired pseudoexperience with hemiplegia. We hypothesized that the PTs' pseudoexperience with hemiplegia would modulate the neural system associated with the understanding of others to elaborately comprehend the physical and mental states associated with hemiplegia. To investigate our hypothesis, we recruited 19 PTs and 19 naïve participants (NPs) to undergo functional MRI (fMRI) for cortical activity measurement while viewing videos of hemiplegic (HHM) and non-hemiplegic (non-HHM) hand movements. The participants subsequently viewed the same videos again outside the MRI scanner, and evaluated the observed hand movements via a questionnaire. Compared to the NPs, the PTs showed greater activation in the AON and rTPJ while observing HHMs. Psychophysiological interaction analyses revealed increased connectivity between the rTPJ and AON when the PTs viewed the HHMs. Behavioral analyses further indicated that the PTs more accurately assessed feeling states associated with HHMs than did NPs. These findings suggest that the PTs' pseudoexperience modulates the AON and rTPJ, enabling them to better understand hemiplegia-associated feeling states.