Dettmers Christian, Nedelko Violetta, Schoenfeld Mircea Ariel
Kliniken Schmieder Konstanz, Eichhornstraße 68, 78464 Konstanz, Germany.
Lurija Institut für Rehabilitationswissenschaften, Postfach 240, 78476 Allensbach, Germany.
Restor Neurol Neurosci. 2015;33(5):701-12. doi: 10.3233/RNN-140487.
Mental training appears to be an attractive tool in stroke rehabilitation. The objective of this study was to investigate whether any differences in the processing of action observation and imagery might exist between patients with left and right hemisphere subcortical strokes.
Eighteen patients with strictly subcortical stroke (nine right-hemispheric) underwent a functional magnetic resonance imaging (fMRI) study with an experimental paradigm in which motor acts had to be observed and/or imagined from a first person perspective. Changes in hemodynamic activity were measured using fMRI.
The activity level was found to be higher in the non-lesioned compared to the lesioned hemisphere. Patients with lesions in the left hemisphere had a higher activation level in visual (fusiform and lingual gyri), superior temporal areas and dorsal premotor regions across all performed comparisons than those with right hemisphere lesions. Furthermore they had more vivid imagery experiences and lower scores on the Stroke Impact Scale.
Patients with left hemisphere subcortical lesions recruit more cortical regions in the processing of action pictures and videos. This recruitment was further enhanced during imagery. This is most likely related to the fact that the lesion touched the dominant hemisphere.
心理训练似乎是中风康复中一种有吸引力的工具。本研究的目的是调查左、右半球皮质下中风患者在动作观察和想象处理方面是否存在差异。
18例严格皮质下中风患者（9例右半球）接受了功能磁共振成像（fMRI）研究，采用一种实验范式，要求从第一人称视角观察和/或想象运动行为。使用fMRI测量血流动力学活动的变化。
发现非病变半球的活动水平高于病变半球。在所有进行的比较中，左半球病变患者在视觉（梭状回和舌回）、颞上区和背侧运动前区的激活水平高于右半球病变患者。此外，他们有更生动的想象体验，且在中风影响量表上得分更低。
左半球皮质下病变患者在处理动作图片和视频时会募集更多的皮质区域。在想象过程中，这种募集进一步增强。这很可能与病变累及优势半球这一事实有关。
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