Department of Neurological, Neuropsychological, Morphological and Movement Sciences, Section of Clinical Neurology, University of Verona, Verona, Italy.
Clin Neurophysiol. 2012 Jan;123(1):142-53. doi: 10.1016/j.clinph.2011.05.028. Epub 2011 Jul 7.
To investigate blood oxygenation level-dependent (BOLD) activation during somatosensory electrical stimulation of the median nerve in acute stroke patients and to determine its correlation with ischemic damage and clinical recovery over time.
Fourteen acute stroke patients underwent functional magnetic resonance imaging (fMRI) during contralesional median-nerve electrical stimulation 12-48 h after stroke. Findings were then validated by diffusion tensor imaging (DTI) and motor evoked potential by transcranial magnetic stimulation (TMS).
Poor clinical recovery at three months was noted in four patients with no activation in the early days after stroke, whereas good clinical recovery was observed in eight patients with a normal activation pattern in the primary sensory motor area in the acute phase. In two patients BOLD activation correlated weakly with clinical recovery. Findings from TMS and DTI partially correlated with clinical recovery and functional scores.
Clinically relevant insights into the "functional reserve" of stroke patients gained with peripheral nerve stimulation during fMRI may carry prognostic value already in the acute period of a cerebrovascular accident.
BOLD activation maps could provide insights into the functional organization of the residual systems and could contribute to medical decision making in neurological and rehabilitative treatment.
研究急性脑卒中患者正中神经体感电刺激时血氧水平依赖（BOLD）激活情况，并确定其与缺血性损伤和随时间推移的临床恢复的相关性。
14 名急性脑卒中患者在脑卒中后 12-48 小时进行功能性磁共振成像（fMRI）检查，对侧正中神经电刺激。然后通过弥散张量成像（DTI）和经颅磁刺激（TMS）运动诱发电位对结果进行验证。
4 名患者在脑卒中早期无激活，3 个月时临床恢复不良，而 8 名患者在急性期初级感觉运动区有正常激活模式，临床恢复良好。在 2 名患者中，BOLD 激活与临床恢复呈弱相关。TMS 和 DTI 的发现与临床恢复和功能评分部分相关。
fMRI 下外周神经刺激获得的脑卒中患者“功能储备”的临床相关见解，可能在脑血管意外的急性期就具有预后价值。
BOLD 激活图可以深入了解残留系统的功能组织，并有助于神经学和康复治疗中的医疗决策。
