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皮质位置相干性作为卒中后早期传入通路完整性的标志物:一项前瞻性队列研究。

Position-Cortical Coherence as a Marker of Afferent Pathway Integrity Early Poststroke: A Prospective Cohort Study.

机构信息

Department of Rehabilitation Medicine, Amsterdam University Medical Centers, Vrije Universiteit Amsterdam, , Amsterdam Neuroscience and Amsterdam Movement Sciences, Amsterdam, The Netherlands.

Department of Biomechanical Engineering, University of Twente, Enschede, The Netherlands.

出版信息

Neurorehabil Neural Repair. 2020 Apr;34(4):344-359. doi: 10.1177/1545968319893289. Epub 2020 Mar 4.

Abstract

. Addressing the role of somatosensory impairment, that is, afferent pathway integrity, in poststroke motor recovery may require neurophysiological assessment. . We investigated the longitudinal construct validity of position-cortical coherence (PCC), that is, the agreement between mechanically evoked wrist perturbations and electroencephalography (EEG), as a measure of afferent pathway integrity. . PCC was measured serially in 48 patients after a first-ever ischemic stroke in addition to Fugl-Meyer motor assessment of the upper extremity (FM-UE) and Nottingham Sensory Assessment hand-finger subscores (EmNSA-HF, within 3 and at 5, 12, and 26 weeks poststroke. Changes in PCC over time, represented by percentage presence of PCC (%PCC), mean amplitude of PCC over the affected (Amp-A) and nonaffected hemisphere (Amp-N) and a lateralization index (L-index), were analyzed, as well as their association with FM-UE and EmNSA-HF. Patients were retrospectively categorized based on FM-UE score at baseline and 26 weeks poststroke into high- and low-baseline recoverers and non-recoverers. . %PCC increased from baseline to 12 weeks poststroke (β = 1.6%, CI = 0.32% to 2.86%, = .01), which was no longer significant after adjusting for EmNSA-HF and FM-UE. A significant positive association was found between %PCC, Amp-A, and EmNSA-HF. Low-baseline recoverers (n = 8) showed longitudinally significantly higher %PCC than high-baseline recoverers (n = 23). . We demonstrated the longitudinal construct validity of %PCC and Amp-A as a measure of afferent pathway integrity. A high %PCC in low-baseline recoverers suggests that this measure also contains information on cortical excitability. Use of PCC as an EEG-based measure to address the role of somatosensory integrity to motor recovery poststroke requires further attention.

摘要

. 探讨躯体感觉损伤(即传入通路完整性)在卒中后运动功能恢复中的作用可能需要神经生理学评估。. 我们研究了位置皮质相干性(PCC)的纵向构建效度,即机械诱发的腕部扰动与脑电图(EEG)之间的一致性,作为传入通路完整性的测量指标。. 在首次缺血性卒中后,除了上肢 Fugl-Meyer 运动评估(FM-UE)和 Nottingham 感觉评估手部手指子项(EmNSA-HF)外,我们还连续测量了 48 例患者的 PCC,分别在 3 天、5 天、12 天和 26 天。通过分析时间上的 PCC 变化(表示为 PCC 百分比存在度(%PCC)、受影响(Amp-A)和未受影响半球(Amp-N)的 PCC 平均幅度以及侧化指数(L-index))及其与 FM-UE 和 EmNSA-HF 的相关性,对 PCC 进行了研究。根据基线和 26 周后 FM-UE 评分,患者被回顾性分为高基线恢复者和低基线恢复者以及无恢复者。. %PCC 从基线到 12 周时增加(β=1.6%,CI=0.32%至 2.86%,P=0.01),但在调整 EmNSA-HF 和 FM-UE 后,这一差异不再显著。%PCC、Amp-A 和 EmNSA-HF 之间存在显著正相关。低基线恢复者(n=8)的 %PCC 纵向显著高于高基线恢复者(n=23)。. 我们证明了 %PCC 和 Amp-A 作为传入通路完整性测量指标的纵向构建效度。低基线恢复者的高 %PCC 表明该测量指标还包含皮质兴奋性的信息。使用 PCC 作为基于 EEG 的测量指标来探讨卒中后运动恢复中躯体感觉完整性的作用还需要进一步关注。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/650d/7168808/898a8a3c1db2/10.1177_1545968319893289-fig1.jpg

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