Samsung Biomedical Research Institute, Department of Physical and Rehabilitation Medicine, Stroke and Cerebrovascular Center, Samsung Medical Center, Sungkyunkwan University School of Medicine, 50 Irwon-dong, Gangnam-gu, Seoul, 135-710, Republic of Korea.
Stroke. 2011 May;42(5):1357-62. doi: 10.1161/STROKEAHA.110.596155. Epub 2011 Mar 24.
Functional MRI (fMRI) studies could provide crucial information on the neural mechanisms of motor recovery in patients with stroke. Resting-state fMRI is applicable to patients with stroke who are not capable of proper performance of the motor task. In this study, we explored neural correlates of motor recovery in patients with stroke by investigating longitudinal changes in resting-state functional connectivity of the ipsilesional primary motor cortex (M1).
A longitudinal observational study using repeated fMRI experiments was conducted in 12 patients with stroke. Resting-state fMRI data were acquired 4 times over a period of 6 months. Patients participated in the first session of fMRI shortly after onset and thereafter in subsequent sessions at 1, 3, and 6 months after onset. Resting-state functional connectivity of the ipsilesional M1 was assessed and compared with that of healthy subjects.
Compared with healthy subjects, patients demonstrated higher functional connectivity with the ipsilesional frontal and parietal cortices, bilateral thalamus, and cerebellum. Instead, functional connectivity with the contralesional M1 and occipital cortex were decreased in patients with stroke. Functional connectivity between the ipsilesional and contralesional M1 showed the most asymmetry at 1 month after onset to the ipsilesional side. Functional connectivity of the ipsilesional M1 with the contralesional thalamus, supplementary motor area, and middle frontal gyrus at onset was positively correlated with motor recovery at 6 months after stroke.
Resting-state fMRI elicited distinctive but comparable results with previous task-based fMRI, presenting complementary and practical values for use in the study of patients with stroke.
功能磁共振成像（fMRI）研究可为脑卒中患者运动功能恢复的神经机制提供重要信息。静息态 fMRI 适用于无法完成运动任务的脑卒中患者。本研究通过研究病灶对侧初级运动皮层（M1）静息态功能连接的纵向变化，探讨脑卒中患者运动恢复的神经相关性。
采用重复 fMRI 实验的纵向观察性研究，纳入 12 例脑卒中患者。在 6 个月的时间内采集 4 次静息态 fMRI 数据。患者在发病后不久接受 fMRI 检查的第一次扫描，然后在发病后 1、3 和 6 个月进行后续扫描。评估并比较病灶对侧 M1 的静息态功能连接。
与健康受试者相比，脑卒中患者表现出与病灶对侧额顶叶皮层、双侧丘脑和小脑更高的功能连接。相反，脑卒中患者病灶对侧 M1 和枕叶皮层的功能连接降低。病灶对侧 M1 和病灶对侧 M1 之间的功能连接在发病后 1 个月时向病灶对侧的偏侧性最大。发病时病灶对侧 M1 与对侧丘脑、辅助运动区和额中回的功能连接与脑卒中后 6 个月的运动恢复呈正相关。
静息态 fMRI 与之前的任务态 fMRI 得出了独特但相似的结果，为脑卒中患者的研究提供了互补和实用的价值。
