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一项关于中风后上肢偏瘫采用强制性运动疗法治疗的功能磁共振成像纵向研究。

A longitudinal study of functional magnetic resonance imaging in upper-limb hemiplegia after stroke treated with constraint-induced movement therapy.

作者信息

Sheng Bi, Lin Ma

机构信息

Department of Rehabilitation Medicine, The Chinese PLA General Hospital, Beijing, PR China.

出版信息

Brain Inj. 2009 Jan;23(1):65-70. doi: 10.1080/02699050802635299.

Abstract

PRIMARY OBJECTIVE

To investigate the correlation of cerebral function reorganization and functional recovery by using functional magnetic resonance imaging (fMRI) with constraint-induced movement therapy (CIMT) for chronic upper-limb hemiparesis in one subject with stroke.

RESEARCH DESIGN

The patient was treated with 2 weeks of CIMT and the unaffected upper-limb was restricted by a splint for 2 weeks. Clinical measures and functional magnetic resonance imaging (fMRI) tests were performed 1 day before the treatment, the day of after the treatment and 2 weeks after the treatment.

MAIN OUTCOMES

Compared with the baseline, Upper Extremity Function Test (UEFT) of the patient's upper limb increased by 29.1% and Simple Test for Evaluating Hand Function (STEF) increased by 18.4%. Before, after and 2 weeks after the treatment, changes of activation in brain by using fMRI were found during the movement of the affected and unaffected hand.

CONCLUSION

CIMT could significantly improve the upper limb movement function of stroke patients and fMRI proved that this kind of change was related with the plasticity change of the cerebrum. The motor function of the unaffected limb could not be affected when it was restricted and the change of the cerebrum excitation area was a transient change.

摘要

主要目的

采用功能磁共振成像(fMRI)研究一名中风后慢性上肢偏瘫患者在接受强制性使用运动疗法(CIMT)时脑功能重组与功能恢复之间的相关性。

研究设计

对该患者进行为期2周的CIMT治疗,并用夹板限制健侧上肢2周。在治疗前1天、治疗当天及治疗后2周进行临床测量和功能磁共振成像(fMRI)测试。

主要结果

与基线相比,患者上肢的上肢功能测试(UEFT)提高了29.1%,手功能简易评估测试(STEF)提高了18.4%。在治疗前、治疗后及治疗后2周,利用fMRI发现患侧手和健侧手运动期间大脑激活的变化。

结论

CIMT可显著改善中风患者的上肢运动功能,fMRI证明这种变化与大脑可塑性变化有关。限制健侧肢体时其运动功能未受影响,大脑兴奋区的变化是一种短暂变化。

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