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中风后5周以上运动恢复期间功能连接无变化;一项纵向静息态功能磁共振成像研究

No changes in functional connectivity during motor recovery beyond 5 weeks after stroke; A longitudinal resting-state fMRI study.

作者信息

Nijboer Tanja C W, Buma Floor E, Winters Caroline, Vansteensel Mariska J, Kwakkel Gert, Ramsey Nick F, Raemaekers Mathijs

机构信息

Utrecht University, Department of Experimental Psychology, Helmholtz Institute, Utrecht, The Netherlands.

Center of Excellence for Rehabilitation Medicine, University Medical Center Utrecht and De Hoogstraat Rehabilitation, Utrecht, The Netherlands.

出版信息

PLoS One. 2017 Jun 8;12(6):e0178017. doi: 10.1371/journal.pone.0178017. eCollection 2017.

Abstract

Spontaneous motor recovery after stroke appears to be associated with structural and functional changes in the motor network. The aim of the current study was to explore time-dependent changes in resting-state (rs) functional connectivity in motor-impaired stroke patients, using rs-functional MRI at 5 weeks and 26 weeks post-stroke onset. For this aim, 13 stroke patients from the EXPLICIT-stroke Trial and age and gender-matched healthy control subjects were included. Patients' synergistic motor control of the paretic upper-limb was assessed with the upper extremity section of the Fugl-Meyer Assessment (FMA-UE) within 2 weeks, and at 5 and 26 weeks post-stroke onset. Results showed that the ipsilesional rs-functional connectivity between motor areas was lower compared to the contralesional rs-functional connectivity, but this difference did not change significantly over time. No relations were observed between changes in rs-functional connectivity and upper-limb motor recovery, despite changes in upper-limb function as measured with the FMA-UE. Last, overall rs-functional connectivity was comparable for patients and healthy control subjects. To conclude, the current findings did not provide evidence that in moderately impaired stroke patients the lower rs-functional connectivity of the ipsilesional hemisphere changed over time.

摘要

中风后的自发运动恢复似乎与运动网络的结构和功能变化有关。本研究的目的是利用中风发作后5周和26周的静息态功能磁共振成像,探索运动功能受损的中风患者静息态(rs)功能连接随时间的变化。为此,纳入了13名来自EXPLICIT中风试验的中风患者以及年龄和性别匹配的健康对照者。在中风发作后2周内以及5周和26周时,使用Fugl-Meyer评估(FMA-UE)的上肢部分对患者患侧上肢的协同运动控制进行评估。结果显示,与对侧rs功能连接相比,运动区域之间同侧的rs功能连接较低,但这种差异并未随时间发生显著变化。尽管用FMA-UE测量的上肢功能有所变化,但未观察到rs功能连接的变化与上肢运动恢复之间存在关联。最后,患者和健康对照者的整体rs功能连接相当。总之,目前的研究结果并未提供证据表明,在中度受损的中风患者中,同侧半球较低的rs功能连接会随时间发生变化。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8871/5464555/5f1c6a6c0ba9/pone.0178017.g001.jpg

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