1 University of California, Irvine, CA, USA.
2 University of Idaho, Moscow, ID, USA.
Neurorehabil Neural Repair. 2019 Sep;33(9):740-750. doi: 10.1177/1545968319862556. Epub 2019 Jul 18.
. Proprioception of fingers is essential for motor control. Reduced proprioception is common after stroke and is associated with longer hospitalization and reduced quality of life. Neural correlates of proprioception deficits after stroke remain incompletely understood, partly because of weaknesses of clinical proprioception assessments. . To examine the neural basis of finger proprioception deficits after stroke. We hypothesized that a model incorporating both neural injury and neural function of the somatosensory system is necessary for delineating proprioception deficits poststroke. . Finger proprioception was measured using a robot in 27 individuals with chronic unilateral stroke; measures of neural injury (damage to gray and white matter, including corticospinal and thalamocortical sensory tracts), neural function (activation of and connectivity of cortical sensorimotor areas), and clinical status (demographics and behavioral measures) were also assessed. . Impairment in finger proprioception was present contralesionally in 67% and bilaterally in 56%. Robotic measures of proprioception deficits were more sensitive than standard scales and were specific to proprioception. Multivariable modeling found that contralesional proprioception deficits were best explained ( = 0.63; = .0006) by a combination of neural function (connectivity between ipsilesional secondary somatosensory cortex and ipsilesional primary motor cortex) and neural injury (total sensory system injury). . Impairment of finger proprioception occurs frequently after stroke and is best measured using a quantitative device such as a robot. A model containing a measure of neural function plus a measure of neural injury best explained proprioception performance. These measurements might be useful in the development of novel neurorehabilitation therapies.
手指本体感觉对于运动控制至关重要。中风后本体感觉会降低，这与住院时间延长和生活质量降低有关。中风后本体感觉缺失的神经相关性仍不完全清楚，部分原因是临床本体感觉评估存在不足。
为了研究中风后手指本体感觉缺失的神经基础，我们假设，一个包含神经损伤和感觉系统神经功能的模型对于描绘中风后本体感觉缺失是必要的。
我们使用机器人测量了 27 名慢性单侧中风患者的手指本体感觉；还评估了神经损伤（灰质和白质损伤，包括皮质脊髓和丘脑皮质感觉束）、神经功能（皮质感觉运动区的激活和连通性）和临床状况（人口统计学和行为测量）。
在 67%的对侧和 56%的双侧出现手指本体感觉障碍。机器人测量的本体感觉缺失比标准量表更敏感，并且更具特异性。多变量模型发现，对侧本体感觉缺失最好由神经功能（对侧次级体感皮层与对侧初级运动皮层之间的连通性）和神经损伤（整个感觉系统损伤）的组合来解释（ = 0.63； =.0006）。
中风后手指本体感觉障碍经常发生，最好使用机器人等定量设备进行测量。包含神经功能测量和神经损伤测量的模型可以最好地解释本体感觉表现。这些测量方法可能有助于开发新的神经康复治疗方法。
