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卒中病灶部位与感觉运动节律的相关性:系统综述与叙述性综合分析。

Association between lesion location and sensorimotor rhythms in stroke - a systematic review with narrative synthesis.

机构信息

UMC Utrecht Brain Center, Department of Neurology & Neurosurgery, University Medical Center Utrecht, P.O. Box 85060, 3508 AB, Utrecht, The Netherlands.

出版信息

Neurol Sci. 2023 Dec;44(12):4263-4289. doi: 10.1007/s10072-023-06982-8. Epub 2023 Aug 22.

Abstract

BACKGROUND

Stroke causes alterations in the sensorimotor rhythms (SMRs) of the brain. However, little is known about the influence of lesion location on the SMRs. Understanding this relationship is relevant for the use of SMRs in assistive and rehabilitative therapies, such as Brain-Computer Interfaces (BCIs)..

METHODS

We reviewed current evidence on the association between stroke lesion location and SMRs through systematically searching PubMed and Embase and generated a narrative synthesis of findings.

RESULTS

We included 12 articles reporting on 161 patients. In resting-state studies, cortical and pontine damage were related to an overall decrease in alpha (∼8-12 Hz) and increase in delta (∼1-4 Hz) power. In movement paradigm studies, attenuated alpha and beta (∼15-25 Hz) event-related desynchronization (ERD) was shown in stroke patients during (attempted) paretic hand movement, compared to controls. Stronger reductions in alpha and beta ERD in the ipsilesional, compared to contralesional hemisphere, were observed for cortical lesions. Subcortical stroke was found to affect bilateral ERD and ERS, but results were highly variable.

CONCLUSIONS

Findings suggest a link between stroke lesion location and SMR alterations, but heterogeneity across studies and limited lesion location descriptions precluded a meta-analysis.

SIGNIFICANCE

Future research would benefit from more uniformly defined outcome measures, homogeneous methodologies, and improved lesion location reporting.

摘要

背景

中风会导致大脑的感觉运动节律(SMR)发生改变。然而,关于病变位置对 SMR 的影响知之甚少。了解这种关系对于 SMR 在辅助和康复治疗中的应用(如脑机接口)至关重要。

方法

我们通过系统地搜索 PubMed 和 Embase,回顾了当前关于中风病变位置与 SMRs 之间关联的证据,并对研究结果进行了叙述性综合分析。

结果

我们纳入了 12 篇报告了 161 名患者的文章。在静息状态研究中,皮质和脑桥损伤与α(约 8-12 Hz)和δ(约 1-4 Hz)功率的总体降低有关。在运动范式研究中,与对照组相比,中风患者在(尝试)瘫痪手运动期间,α 和β(约 15-25 Hz)事件相关去同步(ERD)减弱。与对侧半球相比,皮质病变患者同侧半球的α 和β ERD 减少更为明显。研究发现皮质下中风会影响双侧 ERD 和 ERS,但结果差异很大。

结论

研究结果表明中风病变位置与 SMR 改变之间存在关联,但由于研究之间存在异质性和有限的病变位置描述,无法进行荟萃分析。

意义

未来的研究将受益于更统一的定义的结果测量、同质的方法和改进的病变位置报告。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/ed58/10641054/123a6fcf2a41/10072_2023_6982_Fig1_HTML.jpg

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