Liu Yu, Ma Jiang, Li Hong, Shi Wan-Ying, Xiao Zheng-Hua, Yang Qian, Zhao Qing-Qing, Wang Fang, Tao Xiao-Lin, Bai Yun-Fei
Department of Rehabilitation Medicine, Shijiazhuang People's Hospital, Shijiazhuang, China.
Physical Education College, Hebei Normal University, Shijiazhuang, China.
Front Neurosci. 2023 Jan 11;16:1065629. doi: 10.3389/fnins.2022.1065629. eCollection 2022.
Assessing hand sensation in stroke patients is necessary; however, current clinical assessments are time-consuming and inaccurate.
This study aimed to explore the nature of light touch sensation and two-point discrimination (2-PD) of different hand sites in convalescent stroke patients based on somatosensory evoked potentials (SEP).
Light touch sensation and 2-PD of the thumb, the index finger, the little finger, thenar, and hypothenar were measured ( = 112) using sensory measurement tools. Sensory differences among the hand sites were then compared. The correlation analysis between SEP and the hemiplegic hand function was made. Sensory functions were divided into three levels: sensory intactness, sensory impairment, and sensory loss.
Light touch sensations were mainly associated with sensory impairment in the finger and palm region. The 2-PD of the finger region was mainly sensory loss and that of the palm region was mainly sensory impairment. There was no statistical difference in the light touch sensation among the sites of the hand. The correlation coefficients between the 2-PD and SEP N20 amplitudes differed. The correlation coefficients of the thenar and hypothenar were the smallest, and that of the finger was the largest. Light touch sensation and 2-PD in patients with stroke were related to the hemiplegic hand function.
Any site on the hand could be selected as the measurement site for light touch sensation. The little finger and hypothenar may be appropriate sites when screening for 2-PD. To improve the patient's recovery they could receive more sensory stimulation of the hand.
评估中风患者的手部感觉很有必要；然而，目前的临床评估既耗时又不准确。
本研究旨在基于体感诱发电位（SEP）探讨恢复期中风患者不同手部部位的轻触觉和两点辨别觉（2-PD）的特点。
使用感觉测量工具测量112例患者拇指、食指、小指、大鱼际和小鱼际的轻触觉和2-PD。然后比较手部各部位之间的感觉差异。对SEP与偏瘫手功能进行相关性分析。感觉功能分为三个等级：感觉完好、感觉损害和感觉丧失。
轻触觉主要与手指和手掌区域的感觉损害相关。手指区域的2-PD主要为感觉丧失，手掌区域的2-PD主要为感觉损害。手部各部位的轻触觉无统计学差异。2-PD与SEP N20波幅之间的相关系数不同。大鱼际和小鱼际的相关系数最小，手指的相关系数最大。中风患者的轻触觉和2-PD与偏瘫手功能有关。
手部的任何部位都可作为轻触觉的测量部位。筛查2-PD时，小指和小鱼际可能是合适的部位。为促进患者恢复，可给予手部更多的感觉刺激。
