Lin Yifang, Jiang Zewu, Zhan Gege, Su Haolong, Kang XiaoYang, Jia Jie
Department of Rehabilitation Medicine, Huashan Hospital, Fudan University, Shanghai, China.
Department of Rehabilitation Medicine, Shanghai Jing'an District Central Hospital, Shanghai, China.
Front Neurol. 2023 Jul 19;14:1143955. doi: 10.3389/fneur.2023.1143955. eCollection 2023.
The activation patterns and functional network characteristics between stroke survivors and healthy individuals based on resting-or task-state neuroimaging and neurophysiological techniques have been extensively explored. However, the discrepancy between stroke patients at different recovery stages remains unclear.
To investigate the changes in brain connectivity and network topology between subacute and chronic patients, and hope to provide a basis for rehabilitation strategies at different stages after stroke.
Fifteen stroke survivors were assigned to the subacute group (SG, = 9) and chronic group (CG, = 6). They were asked to perform hand grasping under active, passive, and MI conditions when recording EEG. The Fugl-Meyer Assessment Upper Extremity subscale (FMA_UE), modified Ashworth Scale (MAS), Manual Muscle Test (MMT), grip and pinch strength, modified Barthel Index (MBI), and Berg Balance Scale (BBS) were measured.
Functional connectivity analyses showed significant interactions on frontal, parietal and occipital lobes connections in each frequency band, particularly in the delta band. The coupling strength of premotor cortex, M1, S1 and several connections linked to frontal, parietal, and occipital lobes in subacute subjects were lower than in chronic subjects in low alpha, high alpha, low beta, and high beta bands. Nodal clustering coefficient (CC) analyses revealed that the CC in chronic subjects was higher than in subacute subjects in the ipsilesional S1 and occipital area, contralesional dorsolateral prefrontal cortex and parietal area. Characteristic path length (CPL) analyses showed that CPL in subacute subjects was lower than in chronic subjects in low beta, high beta, and gamma bands. There were no significant differences between subacute and chronic subjects for small-world property.
Subacute stroke survivors were characterized by higher transfer efficiency of the entire brain network and weak local nodal effects. Transfer efficiency was reduced, the local nodal role was strengthened, and more neural resources needed to be mobilized to perform motor tasks for chronic survivors. Overall, these results may help to understand the remodeling pattern of the brain network for different post-stroke stages on task conditions and the mechanism of spontaneous recovery.
基于静息态或任务态神经影像学和神经生理学技术，对中风幸存者与健康个体之间的激活模式和功能网络特征进行了广泛探索。然而，不同恢复阶段中风患者之间的差异仍不清楚。
研究亚急性和慢性患者脑连接性和网络拓扑结构的变化，希望为中风后不同阶段的康复策略提供依据。
15名中风幸存者被分为亚急性组（SG，n = 9）和慢性组（CG，n = 6）。在记录脑电图时，要求他们在主动、被动和运动想象条件下进行手部抓握。测量Fugl-Meyer评估上肢分量表（FMA_UE）、改良Ashworth量表（MAS）、徒手肌力测试（MMT）、握力和捏力、改良Barthel指数（MBI）和Berg平衡量表（BBS）。
功能连接性分析显示，每个频段在额叶、顶叶和枕叶连接上存在显著交互作用，尤其是在δ频段。在低α、高α、低β和高β频段，亚急性受试者的运动前区皮质、M1、S1以及与额叶、顶叶和枕叶相连的几个连接的耦合强度低于慢性受试者。节点聚类系数（CC）分析显示，在患侧S1和枕叶区域、对侧背外侧前额叶皮质和顶叶区域，慢性受试者的CC高于亚急性受试者。特征路径长度（CPL）分析显示，在低β、高β和γ频段，亚急性受试者的CPL低于慢性受试者。亚急性和慢性受试者在小世界属性方面无显著差异。
亚急性中风幸存者的特征是全脑网络的转移效率较高，局部节点效应较弱。慢性幸存者的转移效率降低，局部节点作用增强，执行运动任务需要调动更多神经资源。总体而言，这些结果可能有助于理解不同中风后阶段脑网络在任务条件下的重塑模式以及自发恢复机制。
