Cao Jianwei, Khan Bilal, Hervey Nathan, Tian Fenghua, Delgado Mauricio R, Clegg Nancy J, Smith Linsley, Roberts Heather, Tulchin-Francis Kirsten, Shierk Angela, Shagman Laura, MacFarlane Duncan, Liu Hanli, Alexandrakis George
University of Texas at Arlington and University of Texas Southwestern Medical Center at Dallas, Joint Graduate Program in Biomedical Engineering, Arlington, Texas 76010, United States.
Texas Scottish Rite Hospital for Children, Department of Neurology, Dallas, Texas 75219, United StatesdUniversity of Texas Southwestern Medical Center at Dallas, Department of Neurology, Dallas, Texas 75235, United States.
J Biomed Opt. 2015 Apr;20(4):046009. doi: 10.1117/1.JBO.20.4.046009.
Sensorimotor cortex plasticity induced by constraint-induced movement therapy (CIMT) in six children (10.2±2.1 years old) with hemiplegic cerebral palsy was assessed by functional near-infrared spectroscopy (fNIRS). The activation laterality index and time-to-peak/duration during a finger-tapping task and the resting-state functional connectivity were quantified before, immediately after, and 6 months after CIMT. These fNIRS-based metrics were used to help explain changes in clinical scores of manual performance obtained concurrently with imaging time points. Five age-matched healthy children (9.8±1.3 years old) were also imaged to provide comparative activation metrics for normal controls. Interestingly, the activation time-to-peak/duration for all sensorimotor centers displayed significant normalization immediately after CIMT that persisted 6 months later. In contrast to this improved localized activation response, the laterality index and resting-state connectivity metrics that depended on communication between sensorimotor centers improved immediately after CIMT, but relapsed 6 months later. In addition, for the subjects measured in this work, there was either a trade-off between improving unimanual versus bimanual performance when sensorimotor activation patterns normalized after CIMT, or an improvement occurred in both unimanual and bimanual performance but at the cost of very abnormal plastic changes in sensorimotor activity.
通过功能近红外光谱（fNIRS）评估了6名偏瘫型脑瘫儿童（10.2±2.1岁）在强制性运动疗法（CIMT）诱导下的感觉运动皮层可塑性。在CIMT之前、之后即刻以及6个月后，对在手指敲击任务期间的激活偏侧指数和峰值时间/持续时间以及静息态功能连接进行了量化。这些基于fNIRS的指标用于帮助解释与成像时间点同时获得的手动操作临床评分的变化。还对5名年龄匹配的健康儿童（9.8±1.3岁）进行了成像，以提供正常对照的比较激活指标。有趣的是，所有感觉运动中枢的激活峰值时间/持续时间在CIMT之后即刻显示出显著的正常化，并持续到6个月后。与这种改善的局部激活反应相反，依赖于感觉运动中枢之间通信的偏侧指数和静息态连接指标在CIMT之后即刻有所改善，但在6个月后又复发。此外，对于本研究中测量的受试者，当CIMT后感觉运动激活模式正常化时，单手与双手操作性能的改善之间存在权衡，或者单手和双手操作性能都有所改善，但代价是感觉运动活动出现非常异常的可塑性变化。
