Johansen-Berg Heidi, Dawes Helen, Guy Claire, Smith Stephen M, Wade Derick T, Matthews Paul M
Oxford Centre for Functional Magnetic Resonance Imaging of the Brain, John Radcliffe Hospital and Rivermead Rehabilitation Centre, Oxford, UK.
Brain. 2002 Dec;125(Pt 12):2731-42. doi: 10.1093/brain/awf282.
Motor rehabilitation therapy is commonly employed after strokes, but outcomes are variable and there is little specific information about the changes in brain activity that are associated with improved function. We performed serial functional MRI (fMRI) on a group of seven patients receiving a form of rehabilitation therapy after stroke in order to characterize functional changes in the brain that correlate with behavioural improvements. Patients were scanned while performing a hand flexion-extension movement twice before and twice after a two-week home-based therapy programme combining restraint of the unaffected limb with progressive exercises for the affected limb. As expected, the extent of improvement in hand function after therapy varied between patients. Therapy-related improvements in hand function correlated with increases in fMRI activity in the premotor cortex and secondary somatosensory cortex contralateral to the affected hand, and in superior posterior regions of the cerebellar hemispheres bilaterally (Crus I and lobule VI). fMRI offers a promising, objective approach for specifically identifying changes in brain activity potentially responsible for rehabilitation-mediated recovery of function after stroke. Our results suggest that activity changes in sensorimotor regions are associated with successful motor rehabilitation.
运动康复治疗常用于中风后，但治疗结果各不相同，而且关于与功能改善相关的大脑活动变化的具体信息很少。我们对一组七名中风后接受某种康复治疗的患者进行了系列功能磁共振成像（fMRI）检查，以确定与行为改善相关的大脑功能变化。在一项为期两周的居家治疗方案前后，患者在进行手部屈伸运动时接受了两次扫描，该治疗方案包括限制未受影响的肢体活动，并对受影响的肢体进行渐进式锻炼。正如预期的那样，治疗后患者手部功能的改善程度各不相同。与治疗相关的手部功能改善与患侧手对侧的运动前皮质、次级体感皮质以及双侧小脑半球上后区域（I小叶和VI小叶）的fMRI活动增加相关。fMRI为具体识别可能导致中风后康复介导的功能恢复的大脑活动变化提供了一种有前景的客观方法。我们的结果表明，感觉运动区域的活动变化与成功的运动康复相关。
