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“提醒-移动”治疗增强脑卒中患者初级运动皮层的激活。

"Remind-to-Move" Treatment Enhanced Activation of the Primary Motor Cortex in Patients with Stroke.

机构信息

Department of Rehabilitation Sciences, The Hong Kong Polytechnic University, Kowloon, Hong Kong SAR.

Department of Occupational Therapy, Shanghai YangZhi Rehabilitation Hospital (Shanghai Sunshine Rehabilitation Center), Shanghai, China.

出版信息

Brain Topogr. 2020 Mar;33(2):275-283. doi: 10.1007/s10548-020-00756-7. Epub 2020 Feb 13.

Abstract

"Remind-to-Move" (RTM) has been developed and used as a new treatment for rehabilitation of upper extremity functions in patients with hemiplegia. This study aimed to investigate the cortical activation patterns using functional near-infrared spectroscopic topography for patients with chronic stroke receiving RTM by comparing with their healthy counterparts. Twelve patients with right hemispheric stroke and 15 healthy adults participated in this study. All participants were instructed to completed three experimental conditions-RTM, Move without reminding (Sham), and Remind with No-move (RNoM). In patients with stroke, RTM elicited higher level of activation than the Sham in the contralateral somatosensory association cortex, primary motor cortex, primary somatosensory cortex and the dorsolateral prefrontal cortex, which has been found in healthy participants. However, effects of RTM were robust and more widely distributed in healthy participants, comparing to patients with stroke, comparatively RNoM showed no significant higher activation than the baseline in those areas in both populations. RTM enhances the recruitment of contralateral primary motor cortex and this effect appears to be associated with increased attention allocation towards moving hands upon tactile stimulation in the form of vibration. The RTM treatment is useful to patients with stroke.

摘要

“提醒移动”(RTM)已被开发并用于治疗偏瘫患者上肢功能康复的新方法。本研究旨在通过与健康对照组进行比较,使用功能近红外光谱地形图研究接受 RTM 的慢性中风患者的皮层激活模式。12 名右侧半球中风患者和 15 名健康成年人参加了这项研究。所有参与者都被要求完成三个实验条件-RTM、无提醒移动(Sham)和无移动提醒(RNoM)。在中风患者中,RTM 在对侧感觉运动联合皮层、初级运动皮层、初级感觉皮层和背外侧前额叶皮层中引起的激活水平高于 Sham,这在健康参与者中也有发现。然而,与中风患者相比,RTM 在健康参与者中产生的效果更加强大和广泛,比较而言,RNoM 在这两个群体的这些区域中并没有比基线显示出更高的显著激活。RTM 增强了对侧初级运动皮层的募集,这种效应似乎与触觉刺激(以振动形式)引起的对手部运动的注意力分配增加有关。RTM 治疗对中风患者有效。

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