β 振荡反映亚急性期脑卒中瘫痪上肢的恢复。

β-Oscillations Reflect Recovery of the Paretic Upper Limb in Subacute Stroke.

机构信息

Institute of Brain Science, National Yang-Ming University, Taipei, Taiwan.

Far Eastern Memorial Hospital, New Taipei City, Taiwan.

出版信息

Neurorehabil Neural Repair. 2020 May;34(5):450-462. doi: 10.1177/1545968320913502. Epub 2020 Apr 23.

Abstract

. Recovery of upper limb function post-stroke can be partly predicted by initial motor function, but the mechanisms underpinning these improvements have yet to be determined. Here, we sought to identify neural correlates of post-stroke recovery using longitudinal magnetoencephalography (MEG) assessments in subacute stroke survivors. . First-ever, subcortical ischemic stroke survivors with unilateral mild to moderate hand paresis were evaluated at 3, 5, and 12 weeks after stroke using a finger-lifting task in the MEG. Cortical activity patterns in the β-band (16-30 Hz) were compared with matched healthy controls. All stroke survivors (n=22; 17 males) had improvements in action research arm test (ARAT) and Fugl-Meyer upper extremity (FM-UE) scores between 3 and 12 weeks. At 3 weeks post-stroke the peak amplitudes of the movement-related ipsilesional β-band event-related desynchronization (β-ERD) and synchronization (β-ERS) in primary motor cortex (M1) were significantly lower than the healthy controls (p<0.001) and were correlated with both the FM-UE and ARAT scores (r=0.51-0.69, p<0.017). The decreased β-ERS peak amplitudes were observed both in paretic and non-paretic hand movement particularly at 3 weeks post-stroke, suggesting a generalized disinhibition status. β-ERS at week 3 post-stroke correlated with the FM-UE score at 12 weeks (r=0.54, p=0.03) but no longer significant when controlling for the FM-UE score at 3 weeks post-stroke. Although early β-band activity does not independently predict outcome at 3 months after stroke, it mirrors functional changes, giving a potential insight into the mechanisms underpinning recovery of motor function in subacute stroke.

摘要

. 脑卒中后上肢功能的恢复可以部分预测初始运动功能,但支持这些改善的机制尚未确定。在这里,我们试图通过对亚急性脑卒中幸存者进行纵向脑磁图 (MEG) 评估来确定脑卒中后恢复的神经相关性。. 首次对单侧轻度至中度手部瘫痪的皮质下缺血性脑卒中幸存者在脑卒中后 3、5 和 12 周使用 MEG 中的手指抬起任务进行评估。比较了β 波段(16-30 Hz)的皮质活动模式与匹配的健康对照组。所有脑卒中幸存者(n=22;17 名男性)在脑卒中后 3 至 12 周内,上肢动作研究测试(ARAT)和 Fugl-Meyer 上肢(FM-UE)评分均有改善。在脑卒中后 3 周时,初级运动皮层(M1)的运动相关对侧β 波段事件相关去同步化(β-ERD)和同步化(β-ERS)的峰振幅明显低于健康对照组(p<0.001),并且与 FM-UE 和 ARAT 评分相关(r=0.51-0.69,p<0.017)。脑卒中后 3 周时,双侧瘫痪和非瘫痪手运动的β-ERS 峰振幅均降低,表明存在普遍的抑制解除状态。脑卒中后 3 周的β-ERS 峰振幅与脑卒中后 12 周的 FM-UE 评分相关(r=0.54,p=0.03),但在控制脑卒中后 3 周的 FM-UE 评分后不再显著。尽管早期β 波段活动不能独立预测脑卒中后 3 个月的结果,但它反映了功能变化,为理解亚急性脑卒中运动功能恢复的机制提供了潜在的见解。

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