一项初步的脑磁图和经颅磁刺激研究表明,皮质β振荡和运动阈值在中风后运动障碍的整个范围内存在差异。
Cortical beta oscillations and motor thresholds differ across the spectrum of post-stroke motor impairment, a preliminary MEG and TMS study.
作者信息
Shiner Christine T, Tang Huizhen, Johnson Blake W, McNulty Penelope A
机构信息
Neuroscience Research Australia and University of New South Wales, Sydney, Australia.
Department of Cognitive Science, ARC Centre of Excellence for Cognition and its Disorders, Macquarie University, Sydney, Australia.
出版信息
Brain Res. 2015 Dec 10;1629:26-37. doi: 10.1016/j.brainres.2015.09.037. Epub 2015 Oct 8.
BACKGROUND
Cortical oscillatory activity in the beta frequency band (13-30Hz) is associated with voluntary movement and may be altered in motor disorders such as stroke.
METHODS
We used a multimodal case-series approach to investigate movement-related beta oscillations, cortical excitability and upper-limb motor-function in 10 chronic stroke-patients across a broad range of motor-impairment. Assessments included: (i) whole-head magnetoencephalography (MEG) during a voluntary motor task; (ii) resting and active motor-thresholds to transcranial magnetic stimulation (TMS); and (iii) assessments of upper-limb motor-function.
RESULTS
MEG revealed distinct patterns of movement-related beta oscillations according to motor-function. An elongated event-related desynchronisation (ERD) was correlated with poorer motor-function (p=0.004) whereas an elongated event-related resynchronisation (ERS) was correlated with higher motor function and lower TMS motor thresholds on the more-affected side (p=0.014 and p<0.001, respectively). Oscillation amplitude and laterality were also correlated with motor-function, where a stronger ERD/ERS and a greater relative contribution from the ipsilesional hemisphere were correlated with better motor-function (p=0.016, p=0.025). Unlike TMS responses and motor-function, the temporal profile of beta oscillations was largely symmetrical for movements of the more- and less-affected hands.
CONCLUSIONS
Beta ERD/ERS patterns differ across the post-stroke motor impairment spectrum, and are bilaterally similar after stroke. Both the amplitude and duration of beta oscillations relate to post-stroke motor-function.
SIGNIFICANCE
The contralesional hemisphere is not unaffected post-stroke. Caution is needed when generalising imaging and neurophysiological findings from patients with moderate to high motor ability to the more heterogeneous general stroke population and particularly those with low levels of residual voluntary motor-function.
背景
β频段(13 - 30Hz)的皮层振荡活动与自主运动相关,在中风等运动障碍中可能会发生改变。
方法
我们采用多模态病例系列方法,对10名慢性中风患者在广泛的运动损伤范围内的运动相关β振荡、皮层兴奋性和上肢运动功能进行研究。评估包括:(i)自主运动任务期间的全脑磁脑电图(MEG);(ii)经颅磁刺激(TMS)的静息和主动运动阈值;(iii)上肢运动功能评估。
结果
MEG显示根据运动功能存在不同的运动相关β振荡模式。延长的事件相关去同步化(ERD)与较差的运动功能相关(p = 0.004),而延长的事件相关再同步化(ERS)与较高的运动功能以及患侧较低的TMS运动阈值相关(分别为p = 0.014和p < 0.001)。振荡幅度和偏侧性也与运动功能相关,更强的ERD/ERS和患侧半球更大的相对贡献与更好的运动功能相关(p = 0.016,p = 0.025)。与TMS反应和运动功能不同,β振荡的时间特征对于患侧和未患侧手的运动在很大程度上是对称的。
结论
中风后运动损伤范围内的β ERD/ERS模式不同,中风后双侧相似。β振荡的幅度和持续时间均与中风后运动功能有关。
意义
中风后对侧半球并非未受影响。将具有中度至高运动能力患者的影像学和神经生理学发现推广到更具异质性的一般中风人群,特别是那些残余自主运动功能水平较低的人群时,需要谨慎。