Department of Physical Therapy, College of Health and Therapy, Daegu Haany University, Daegu, Republic of Korea.
NeuroRehabilitation. 2011;29(4):359-64. doi: 10.3233/NRE-2011-0713.
Many studies have reported that stroke patients can be accompanied by motor deficit of the unaffected extremities as well as the affected extremities. This suggests that neural control of motor function of unaffected extremities might be changed following stroke. However, very little is known about this topic. Using functional MRI (fMRI), we investigated changes in neural control of motor function of the unaffected hand in hemiparetic patients with cerebral infarct. Thirty-five hemiparetic stroke patients were recruited for this study. fMRI was performed at 1.5T during either affected or unaffected hand flexion-extension movements. We evaluated motor function of the affected upper extremity using the upper Motricity index (UMI) and the medical research council (MRC) scale for finger extensor. From fMRI, LI (laterality index) was calculated for assessment of relative activity in the ipsilateral versus the contralateral primary sensorimotor cortex. Positive correlation between LIs was observed during affected and unaffected hand movements (r=0.670, p=0.000). LI of unaffected hand movements was also correlated with the affected UMI (r=0.408, p=0.015) and MRC of the affected hand extensor (r=0.362, p=0.033). We demonstrated that the ipsilateral (affected) motor cortex was recruited by unaffected hand movements in proportion to poor motor function of the affected upper extremity.
许多研究报告表明，中风患者除了患侧肢体运动功能障碍外，还可能伴有健侧肢体的运动功能障碍。这表明中风后对健侧肢体运动功能的神经控制可能会发生变化。然而，对于这个问题，我们知之甚少。本研究使用功能磁共振成像（fMRI）研究脑梗死偏瘫患者健侧手运动功能的神经控制变化。本研究共纳入 35 例偏瘫中风患者。在 1.5T 磁共振成像仪上分别进行患侧和健侧手屈伸运动时的 fMRI 检查。我们采用上肢运动评估量表（UMI）和手指伸肌的医学研究委员会（MRC）量表评估患侧上肢的运动功能。通过 fMRI 计算运动偏侧指数（LI）来评估对侧初级感觉运动皮层的相对活动。患侧和健侧手运动时均观察到 LI 之间存在正相关（r=0.670，p=0.000）。健侧手运动的 LI 与患侧 UMI（r=0.408，p=0.015）和患侧手伸肌的 MRC（r=0.362，p=0.033）也存在相关性。我们证明，在患侧运动皮层中，健侧手运动时会按比例募集健侧肢体运动功能较差的同侧运动皮层。
