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大脑半球间皮质相互作用在卒中后运动功能中的作用。

Role of Interhemispheric Cortical Interactions in Poststroke Motor Function.

机构信息

1 Emory University, Atlanta, GA, USA.

3 Georgia Institute of Technology, Atlanta, GA, USA.

出版信息

Neurorehabil Neural Repair. 2019 Sep;33(9):762-774. doi: 10.1177/1545968319862552. Epub 2019 Jul 22.

Abstract

. We investigated interhemispheric interactions in stroke survivors by measuring transcranial magnetic stimulation (TMS)-evoked cortical coherence. We tested the effect of TMS on interhemispheric coherence during rest and active muscle contraction and compared coherence in stroke and older adults. We evaluated the relationships between interhemispheric coherence, paretic motor function, and the ipsilateral cortical silent period (iSP). . Participants with (n = 19) and without (n = 14) chronic stroke either rested or maintained a contraction of the ipsilateral hand muscle during simultaneous recordings of evoked responses to TMS of the ipsilesional/nondominant (i/ndM1) and contralesional/dominant (c/dM1) primary motor cortex with EEG and in the hand muscle with EMG. We calculated pre- and post-TMS interhemispheric beta coherence (15-30 Hz) between motor areas in both conditions and the iSP duration during the active condition. . During active i/ndM1 TMS, interhemispheric coherence increased immediately following TMS in controls but not in stroke. Coherence during active cM1 TMS was greater than iM1 TMS in the stroke group. Coherence during active iM1 TMS was less in stroke participants and was negatively associated with measures of paretic arm motor function. Paretic iSP was longer compared with controls and negatively associated with clinical measures of manual dexterity. There was no relationship between coherence and. iSP for either group. No within- or between-group differences in coherence were observed at rest. . TMS-evoked cortical coherence during hand muscle activation can index interhemispheric interactions associated with poststroke motor function and potentially offer new insights into neural mechanisms influencing functional recovery.

摘要

我们通过测量经颅磁刺激(TMS)诱发的皮质相干性来研究脑卒中幸存者的大脑半球间相互作用。我们测试了 TMS 在静息和主动肌肉收缩期间对大脑半球间相干性的影响,并比较了脑卒中患者和老年人的相干性。我们评估了大脑半球间相干性、患侧运动功能和同侧皮质静息期(iSP)之间的关系。

参与者包括 19 名患有慢性脑卒中的患者和 14 名无脑卒中的患者,他们在对同侧手肌肉进行经颅磁刺激(i/ndM1 和 c/dM1)的诱发电反应同时进行记录时,要么休息,要么保持同侧手肌肉收缩,记录过程中使用脑电图记录大脑皮质运动区,使用肌电图记录手部肌肉。我们在两种情况下计算了刺激前和刺激后的大脑半球间β相干性(15-30 Hz),并在主动状态下计算了 iSP 持续时间。

在主动 i/ndM1 TMS 期间,对照组在 TMS 后立即增加了大脑半球间的相干性,但脑卒中患者则没有。在脑卒中患者中,主动 cM1 TMS 的相干性大于 iM1 TMS。在脑卒中患者中,主动 iM1 TMS 的相干性较低,与患侧手臂运动功能的测量值呈负相关。与对照组相比,患侧 iSP 较长,与手动灵巧性的临床测量值呈负相关。两组之间的相干性和 iSP 均无关系。在静息状态下,两组之间均未观察到相干性的组内或组间差异。

在手肌肉激活期间,TMS 诱发的皮质相干性可以反映与脑卒中后运动功能相关的大脑半球间相互作用,并可能为影响功能恢复的神经机制提供新的见解。

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Role of Interhemispheric Cortical Interactions in Poststroke Motor Function.大脑半球间皮质相互作用在卒中后运动功能中的作用。
Neurorehabil Neural Repair. 2019 Sep;33(9):762-774. doi: 10.1177/1545968319862552. Epub 2019 Jul 22.
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