Longitudinal Evaluation of Resting-State fMRI After Acute Stroke With Hemiparesis
Longitudinal Evaluation of Resting-State fMRI After Acute Stroke With Hemiparesis
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DOI：
10.1177/1545968312457827
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发表时间：
2013-02-01
影响因子：
4.2
通讯作者：
Goodyear, Bradley G.
中科院分区：
文献类型：
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作者：
Golestani, Ali-Mohammad;Tymchuk, Sarah;Goodyear, Bradley G.
背景。中风后运动障碍的功能磁共振成像 (fMRI) 在很大程度上取决于患者的努力和运动能力。因此，功能磁共振成像在临床管理中的应用有限。或者，静息态功能磁共振成像（即没有任务）可以通过确定大脑区域之间的时间同步性来阐明大脑的功能连接。客观的。作者研究了静息态功能磁共振成像是否可以阐明缺血性中风数小时内以及恢复期间功能连接的中断。方法。总共 51 名缺血性中风患者，其中 31 名患有轻度至中度手部缺陷（美国国立卫生研究院中风量表 [NIHSS] 运动评分 ayen1），20 名 NIHSS 评分为 0 分，在中风后 24 小时、7 天和 90 天进行静息态 fMRI； 15名年龄匹配的健康人参加1次。使用来自同侧运动皮层的静息态功能磁共振成像信号，计算与对侧运动皮层的功能连接的强度。还生成了静息状态运动网络的全脑图，并在各组和会话之间进行比较。结果。中风后数小时内，运动缺陷患者的连接性显着低于对照组 (P = .02) 和无运动损伤患者 (P = .03)。恢复的（即 NIHSS 评分 = 0）参与者 7 天后重新建立连接。 90 天后，康复患者表现出正常的运动连接性；然而，与努力和认知处理相关的皮层下区域的连通性仍然减少。结论。缺血性中风后数小时内的静息态功能磁共振成像可以证明中风对整个大脑功能连接的影响。该工具有可能帮助在急性成像环境中选择适当的中风疗法并监测康复效果。
Background. Functional magnetic resonance imaging (fMRI) of motor impairment after stroke strongly depends on patient effort and capacity to make a movement. Hence fMRI has had limited use in clinical management. Alternatively, resting-state fMRI (ie, with no task) can elucidate the brain's functional connections by determining temporal synchrony between brain regions. Objective. The authors examined whether resting-state fMRI can elucidate the disruption of functional connections within hours of ischemic stroke as well as during recovery. Methods. A total of 51 ischemic stroke patients-31 with mild-to-moderate hand deficits (National Institutes of Health Stroke Scale [NIHSS] motor score ayen1) and 20 with NIHSS score of 0-underwent resting-state fMRI at < 24 hours, 7 days, and 90 days poststroke; 15 age-matched healthy individuals participated in 1 session. Using the resting-state fMRI signal from the ipsilesional motor cortex, the strength of functional connections with the contralesional motor cortex was computed. Whole-brain maps of the resting-state motor network were also generated and compared between groups and sessions. Results. Within hours poststroke, patients with motor deficits exhibited significantly lower connectivity than controls (P = .02) and patients with no motor impairment (P = .03). Connectivity was reestablished after 7 days in recovered (ie, NIHSS score = 0) participants. After 90 days, recovered patients exhibited normal motor connectivity; however, reduced connectivity with subcortical regions associated with effort and cognitive processing remained. Conclusion. Resting-state fMRI within hours of ischemic stroke can demonstrate the impact of stroke on functional connections throughout the brain. This tool has the potential to help select appropriate stroke therapies in an acute imaging setting and to monitor the efficacy of rehabilitation.