运动想象训练对卒中后患者上肢运动功能恢复的 影响及静息态 fNIRS 脑网络特征研究.

Objective：To evaluate the effect of motor imagery training(MIT) on upper extremity motor function in poststroke patients and the functional connectivity(FC) characteristics of the MIT brain network using functional near-infrared spectroscopy（fNIRS).Method：Seventy-eight post-stroke patients were randomly divided into the control group and treatment group, with 39 patients in each group. The control group received conventional rehabilitation training 100 min/day, 6 times/week, for 3 weeks. The treatment group received MIT 30min/day, 6 times/week based on the control group, for 3 weeks. The Fugl-Meyer Assessment of Upper Extremity(FMA-UE) was performed before and 3 weeks after intervention. Ten patients with left-sided hemiparesis and lesions in the basal ganglia region were selected from each of the two groups. 10 min resting- state fNIRS data were collected from each of the two groups and the brain functional connectivity was calculated. The graph theoretical analysis was further applied to investigate the alterations in regions of interest(ROI), including the prefrontal cortex(PFC), dorsolateral prefrontal cortex(DLPFC), pre-motor and supplementary motor cortex(PMC&SMA), somatosensory association cortex(SSAC) and sensorimotor cortex(SMC). The correlation between the Relative ∆PMC&SMA, Relative ∆SMC blood oxygen and the relative increments of Relative ∆FMA-UE scores were calculated by the Person correlation test. Result：After 3 weeks intervention, the FMA-UE score was improved compared with that before intervention in both groups(P<0.05). The treatment group had a significant difference in FMA-UE score(P<0.05). Resting-state FC analysis showed that FC increased in all channels between the two groups, and there was a significant difference between the two groups(P<0.01). There was significant difference in ROI- ROI after 3 weeks intervention(0.01<P<0.05) included：L_PFC- R_SSAC, L_DLPFC- R_SSAC, L_PFC- R_SMC, R_SACL_DLPFC, R_SAC-L_SSAC, R_SAC-R_PMC &R_SMA, R_SMC-L_SSAC, R_SMC-SMC-L_DLPFC, R_SMCR_PMC &R_SMA. There was a positive correlation between Relative ∆ PMC&SMA blood oxygen and Relative ∆FMA-UE scores in the treatment group(r=0.658, P=0.039). Conclusion：MIT could promote the improvement of upper limb motor function in post-stroke patients. It was possibly related to changing the abnormality mode of the brain function network, such as increasing the inherent FC of the inter-hemispheric motor cortex and increasing resting-state FC strength(including damaged hemispherical motor cortex with unaffected hemispherical motor cortex, damaged hemispherical frontal cortex). [ABSTRACT FROM AUTHOR]