Lin Zhi-cheng, Tao Jing, Gao Yan-lin, Yin Da-zhi, Chen A-zhen, Chen Li-dian
Department of Rehabilitation Medicine, Rehabilitation Hospital, Fujian University of Traditional Chinese Medicine, Fujian, China.
Shanghai Key Laboratory of Magnetic Resonance, East China Normal University, Shanghai, China.
J Int Med Res. 2014 Jun;42(3):659-68. doi: 10.1177/0300060513505809. Epub 2014 Apr 10.
To investigate the central mechanism of cognitive training in patients with stroke, using resting state (RS) functional magnetic resonance imaging (fMRI).
Patients with stroke and executive function and memory deficit were randomized to receive computer-assisted cognitive training (treatment group; total 60 h training over 10 weeks) or no training (control group). All participants received neuropsychological assessment and RS fMRI at baseline and 10 weeks.
Patients in the treatment group (n = 16) showed increased functional connectivity (FC) of the hippocampus with the frontal lobe (right inferior, right middle, left middle, left inferior and left superior frontal gyrus) and left parietal lobe at 10 weeks compared with baseline. Patients in the control group (n = 18) showed decreased FC of the left hippocampus-right occipital gyrus, and right hippocampus-right posterior lobe of cerebellum and left superior temporal gyrus. Significant correlations were found between improved neuropsychological scores and increased FC of the hippocampus with the frontal lobe and left parietal lobe in the treatment group only.
Increased RS FC of the hippocampus with the frontal and parietal lobes may be an important mechanism of cognitive recovery after stroke.
使用静息态(RS)功能磁共振成像(fMRI)研究中风患者认知训练的中枢机制。
将患有中风且存在执行功能和记忆缺陷的患者随机分为接受计算机辅助认知训练(治疗组;在10周内共进行60小时训练)或不接受训练(对照组)。所有参与者在基线和10周时接受神经心理学评估和RS fMRI检查。
与基线相比,治疗组(n = 16)的患者在10周时海马体与额叶(右侧下、右侧中、左侧中、左侧下和左侧额上回)以及左侧顶叶的功能连接(FC)增加。对照组(n = 18)的患者左侧海马体-右侧枕叶、右侧海马体-右侧小脑后叶以及左侧颞上回的FC降低。仅在治疗组中,神经心理学评分的改善与海马体与额叶和左侧顶叶FC的增加之间存在显著相关性。
海马体与额叶和顶叶的静息态FC增加可能是中风后认知恢复的重要机制。