Tunik Eugene, Adamovich Sergei V
University of Medicine and Dentistry of New Jersey, Newark, NJ 07107 USA.
Annu Int Conf IEEE Eng Med Biol Soc. 2009;2009:1139-42. doi: 10.1109/IEMBS.2009.5335392.
In a single case longitudinal study, a 70 year old female subject who has had a subcortical stroke 8 years prior, was tested three times in fMRI using an interactive MRI-compatible VR environment. The subject performed sequential finger movements with her right (unaffected) hand. Her hand motion (recorded with the data glove) animated either the ipsilateral (corresponding) or contralateral (mirrored) virtual hand model. In a visual feedback control condition, the virtual hand models were replaced with ellipsoids. In between the second and third session, the patient participated in an intensive, two-week long VR-based training of her affected upper extremity. When comparing activation in the mirrored versus the non-mirrored virtual visual feedback condition, no significant activation was noted in motor or premotor areas in the baseline 1 or baseline 2 sessions. However, increased activation in the ipsilesional motor cortex occurred as a result of training, despite the absence of active involvement of the ipsilesional motor cortex in this condition. The left motor cortex was also recruited in this condition (though weaker) despite the subtracted out ellipsoid condition (in which subjects also moved their hand). Thus, the contralateral (mirrored) visual feedback may have had a facilitory effect bilaterally. These findings might have some important implications for the development of novel therapies in the acute phase, when paresis and the potential for neural remapping are greatest.
在一项单病例纵向研究中，一名8年前发生过皮质下中风的70岁女性受试者，使用与MRI兼容的交互式虚拟现实（VR）环境在功能磁共振成像（fMRI）中接受了三次测试。受试者用她的右手（未受影响的手）进行连续的手指运动。她的手部动作（用数据手套记录）驱动同侧（对应）或对侧（镜像）虚拟手模型做出动画。在视觉反馈控制条件下，虚拟手模型被椭球体取代。在第二次和第三次测试之间，患者参加了为期两周的针对其受影响上肢的强化VR训练。在比较镜像与非镜像虚拟视觉反馈条件下的激活情况时，在基线1或基线2测试中，运动或运动前区未发现明显激活。然而，尽管在此条件下患侧运动皮层没有积极参与，但训练导致患侧运动皮层的激活增加。尽管减去了椭球体条件（在此条件下受试者也移动了他们的手），但在此条件下左侧运动皮层也被激活（尽管较弱）。因此，对侧（镜像）视觉反馈可能对两侧都有促进作用。这些发现可能对急性期新疗法的开发具有一些重要意义，因为在急性期麻痹和神经重新映射的可能性最大。
