Gao Jingchun, Yang Canhong, Li Qixiong, Chen Lanpin, Jiang Yijing, Liu Songyan, Zhang Jing, Liu Gang, Chen Junqi
Department of Rehabilitation Medicine, Third Affiliated Hospital of Southern Medical University, Guangzhou, China.
Department of Rehabilitation Medicine, Foshan Hospital of Traditional Chinese Medicine, Foshan, China.
Front Aging Neurosci. 2021 Jul 9;13:691518. doi: 10.3389/fnagi.2021.691518. eCollection 2021.
To explore the different compensatory mechanisms of brain function between the patients with brain dysfunction after acute ischemic stroke (AIS) in the dominant hemisphere and the non-dominant hemisphere based on Resting-state Functional Magnetic Resonance Imaging (Rs-fMRI).
In this trial, 15 healthy subjects (HS) were used as blank controls. In total, 30 hemiplegic patients with middle cerebral artery acute infarction of different dominant hemispheres were divided into the dominant hemisphere group (DH) and the non-dominant hemisphere group (NDH), scanned by a 3.0 T MRI scanner, to obtain the amplitude of low-frequency fluctuations (ALFF) and regional homogeneity (ReHo) and compare the differences.
Compared with the HS, increased ALFF values in the brain areas, such as the bilateral midbrain, were observed in DH. Meanwhile decreased ReHo values in the brain areas, such as the right postcentral gyrus (BA3), were also observed. Enhanced ALFF values in the brain areas, such as the left BA6, and enhanced ReHo values in the brain areas, such as the left precuneus, were observed in the NDH. The ALFF and ReHo values of the right BA9 and precentral gyrus were both increased. Compared with DH, the NDH group showed lower ALFF values in the left supplementary motor area and lower ReHo values in the right BA10.
After acute infarction in the middle cerebral artery of the dominant hemisphere, a compensation mechanism is triggered in brain areas of the ipsilateral cortex regulating motor-related pathways, while some brain areas related to cognition, sensation, and motor in the contralateral cortex are suppressed, and the connection with the peripheral brain regions is weakened. After acute infarction in the middle cerebral artery of the non-dominant hemisphere, compensatory activation appears in motor control-related brain areas of the dominant hemisphere. After acute middle cerebral artery infarction in the dominant hemisphere, compared with the non-dominant hemisphere, functional specificity in the bilateral supplementary motor area weakens. After acute middle cerebral artery infarction in different hemispheres, there are hemispheric differences in the compensatory mechanism of brain function.
基于静息态功能磁共振成像(Rs-fMRI)探讨优势半球与非优势半球急性缺血性脑卒中(AIS)后脑功能障碍患者脑功能的不同代偿机制。
本试验选取15名健康受试者(HS)作为空白对照。将30例不同优势半球的大脑中动脉急性梗死偏瘫患者分为优势半球组(DH)和非优势半球组(NDH),采用3.0T MRI扫描仪进行扫描,获取低频振幅(ALFF)和局部一致性(ReHo),并比较差异。
与HS相比,DH组双侧中脑等脑区的ALFF值升高。同时,右侧中央后回(BA3)等脑区的ReHo值降低。NDH组左侧BA6等脑区的ALFF值增强,左侧楔前叶等脑区的ReHo值增强。右侧BA9和中央前回的ALFF和ReHo值均升高。与DH组相比,NDH组左侧辅助运动区的ALFF值较低,右侧BA10的ReHo值较低。
优势半球大脑中动脉急性梗死后,同侧皮质调节运动相关通路的脑区触发代偿机制,而对侧皮质一些与认知、感觉和运动相关的脑区受到抑制,与周边脑区的联系减弱。非优势半球大脑中动脉急性梗死后,优势半球运动控制相关脑区出现代偿性激活。优势半球大脑中动脉急性梗死后,与非优势半球相比,双侧辅助运动区的功能特异性减弱。不同半球大脑中动脉急性梗死后,脑功能代偿机制存在半球差异。