基于多模态fMRI研究慢性期皮层下脑卒中偏瘫患者rTMS决策方案的脑网络连接界点及作用机制

批准号:
81974356
项目类别:
面上项目
资助金额:
55.0 万元
负责人:
孙莉敏
依托单位:
学科分类:
康复治疗与康复机制
结题年份:
2023
批准年份:
2019
项目状态:
已结题
项目参与者:
孙莉敏
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中文摘要
重复经颅磁刺激(rTMS)是脑卒中偏瘫康复的新技术,但目前基于半球间抑制(IHI)失衡理论的标准化rTMS治疗方案疗效不尽如人意。卒中恢复可能遵循双模态平衡恢复模式(IHI模式或健侧代偿模式),有学者提出用结构保留度的界点值来决策rTMS治疗方案,但功能或有效性网络连接参数的界点尚无人研究。课题组前期fMRI研究发现卒中组健侧背侧运动前区(cPMd)的中介中心性和患肢运动评分呈正相关,说明cPMd作用效率越高则患者运动功能越好。笔者提出cPMd为新的靶点脑区可能在健侧代偿模式中发挥重要作用。本课题拟通过脑卒中随机对照研究观察不同rTMS治疗方案(cM1低频、cPMd高频及假刺激)疗效,干预前、干预3周后及治疗结束后4周进行多模态fMRI(DTI、rs-fMRI和tb-fMRI)检查,寻找可能存在的结构、功能或有效性网络连接参数界点,探讨rTMS的脑重塑作用机制,目前此类研究国内外未见报道。
英文摘要
Repeated transcranial magnetic stimulation (rTMS) is a new therapy for stroke patients with hemiplegia, but the standard rTMS treatment strategy according to the theory of imbalance interhemispheric inhibition (IHI) often fails to meet the expectations of patients. During recovery a bimodal balance–recovery model (IHI and vicariation model) might exist. The structural reserve spared by the lesion has been studied as cut-off to decide which rTMS treatment strategy, while the functional or effective cerebral network connectivity parameter as cut-off has not been covered. Our previous study has noted changes in resting-state functional connectivity between stroke group and healthy control group. We observed positive correlations between betweenness centrality in the contralesional dorsolateral premotor cortex (cPMd) and Fugl-Meyer assessment scores. Our result suggests that increased working efficiency of cPMd implies good outcomes in stroke patients. Therefore, cPMd might be the target brain region in cerebral plasticity according to the contralesional vicariation model. Chronic subcortical stroke patients will be randomly divided into three groups (low frequency cM1, high frequency cPMd or sham rTMS for 3 weeks), multimodal-fMRI including DTI, rs-fMRI and tb-fMRI will be applied on all the patients before, after rTMS interventions and at 4-week follow-up. We will find the structural, functional or effective cerebral network connectivity parameter as cut-off and the possible mechanism of cerebral plasticity. This kind of rTMS longitudinal study has not been reported before.
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DOI:10.3760/cma.j.issn.0254-1424.2020.06.003
发表时间:2020
期刊:中华物理医学与康复杂志
影响因子:--
作者:孙莉敏;杨浩;孙长慧;朱秉;范明霞;吴毅;王鹤玮
通讯作者:王鹤玮
Motor Imagery Training After Stroke Increases Slow-5 Oscillations and Functional Connectivity in the Ipsilesional Inferior Parietal Lobule
中风后的运动想象训练可增加同侧顶下小叶的 Slow-5 振荡和功能连接
DOI:10.1177/1545968319899919
发表时间:2020-02
期刊:Neurorehabilitation and Neural Repair
影响因子:4.2
作者:Wang Xu;Wang Hewei;Xiong Xin;Sun Changhui;Zhu Bing;Xu Yiming;Fan Mingxia;Tong Shanbao;Sun Limin;Guo Xiaoli
通讯作者:Guo Xiaoli
DOI:10.12015/issn.1674-8034.2021.07.008
发表时间:2021
期刊:磁共振成像
影响因子:--
作者:魏彧;余秋蓉;尹大志;王鹤玮;孙莉敏;徐国军;詹爽;王雪飞;郭苗;刘凡;范明霞
通讯作者:范明霞
DOI:10.3969/j.issn.1001-1242.2021.12.021
发表时间:2021
期刊:中国康复医学杂志
影响因子:--
作者:樊蕴辉;吴毅;孙莉敏
通讯作者:孙莉敏
DOI:10.12015/issn.1674-8034.2022.06.006
发表时间:2022
期刊:磁共振成像
影响因子:--
作者:郭苗;徐国军;余秋蓉;王鹤玮;尹大志;孙莉敏;宁瑞鹏;刘凡;范明霞
通讯作者:范明霞
基于静息态和任务态的脑网络连接性fMRI研究运动想象训练促进皮层下脑卒中患者功能恢复的作用机制
- 批准号:81401859
- 项目类别:青年科学基金项目
- 资助金额:23.0万元
- 批准年份:2014
- 负责人:孙莉敏
- 依托单位:
国内基金
海外基金
