| 王佳灵,宋建飞,贾欣宇,陈健尔.基于动作和任务的运动想象对脑卒中患者运动皮层区激活的影响[J].中国康复,2025,40(12):721-726 |
| 基于动作和任务的运动想象对脑卒中患者运动皮层区激活的影响 |
| Effects of movement and task-based motor imagery on motor cortical activation patterns in stroke patients |
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| DOI：10.3870/zgkf.2025.12.003 |
| 中文关键词: 脑卒中；运动想象；基于任务的运动想象 近红外脑功能成像；氧合血红蛋白；运动皮层区 |
| 英文关键词: stroke motor imagery task-based motor imagery functional near-infrared spectroscopy oxyhemoglobin motor cortex area |
| 基金项目:浙江省医药卫生科技计划项目(2022KY1049) |
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| 中文摘要: |
| 目的：采用功能性近红外光谱技术（fNIRS）分析比较脑卒中患者进行基于动作的运动想象(MMI）和基于任务的运动想象（TMI）时大脑运动皮层氧合血红蛋白(HbO2)的浓度变化以及脑区的激活情况，为运动想象(MI）疗法提供神经影像学依据。方法：连续入组2022年1~12月在浙江康复医疗中心接受康复治疗的20名左侧脑卒中患者，采用Block设计，随机进行MMI和TMI任务。采用便携式近红外脑功能成像设备对双侧感觉运动区（SMC）、运动前区（PMC）和辅助运动区（SMA）检测HbO2浓度变化，比较两种运动想象（MI）状态下各脑区的激活程度（β值）。结果：根据HbO2浓度，脑卒中患者在MMI任务显著激活16个通道，TMI任务显著激活19个通道，TMI任务期间第3通道激活平均 β 值显著高于MMI（T=4.31，P<0.05）。患者执行TMI任务时视觉想象评分显著高于MMI（Z=-2.013，P<0.05）。结论：MMI和TMI均能显著激活脑卒中患者双侧大脑SMC、PMC、SMA。TMI期间激活范围更广且部分区域激活更强，其任务的目标导向性提升了MI的生动性。 |
| 英文摘要: |
| Objective: To analyze and compare the concentration changes of oxyhemoglobin (HbO2) in the motor cortex and the activation patterns of brain regions in stroke patients during Movement-Based Motor Imagery (MMI) and Task-Based Motor Imagery (TMI) using functional near-infrared spectroscopy (fNIRS). This aims to provide neuroimaging evidence for motor imagery (MI) therapy. Methods: Totally, 20 patients with left-sided stroke receiving rehabilitation therapy at Zhejiang Rehabilitation Medical Center between January and December 2022 were consecutively enrolled. A block design was employed, with participants randomly performing both MMI and TMI tasks. A portable fNIRS device monitored HbO2 concentration changes in the bilateral sensorimotor cortex (SMC), premotor cortex (PMC), and supplementary motor area (SMA). The activation levels (β-values) of these brain regions were compared between the two MI states. Results: Totally, 20 patients were included in the statistical analysis. Based on HbO2 concentration, stroke patients exhibited significant activation in 16 channels during the MMI task and 19 channels during the TMI task. The mean activation β-value in channel 3 was significantly higher during TMI than MMI (T=4.31, P<0.05). Patients also reported significantly higher visual imagery scores during the TMI task than during MMI (Z=-2.013, P<0.05). Conclusion: Both MMI and TMI significantly activated the bilateral SMC, PMC, and SMA in stroke patients. Activation during TMI covered a broader range and was stronger in specific regions. The goal-directed task of TMI likely contributed to its higher vividness of imagination. |
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