视觉刺激对脑干卒中吞咽困难患者皮质活动的影响：一项功能近红外光谱研究。

The effects of visual stimulation on the cortical activity of brainstem stroke dysphagia patients: A functional near-infrared spectroscopy study.

作者信息

Zhao Dandan, Li Yancun, Ning Keyi, Zou Bingjie, Wang Bin, Li Libo, Zhang Qiaojun, Hui Yanping

机构信息

Department of Rehabilitation Medicine, The Second Affiliated Hospital, Xi'an Jiaotong University, Xi'an, China.

出版信息

PLoS One. 2025 Jun 6;20(6):e0325510. doi: 10.1371/journal.pone.0325510. eCollection 2025.

DOI:10.1371/journal.pone.0325510

PMID:40478896

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC12143532/

Abstract

OBJECTIVE

To investigate the difference in cortical activity under food visual stimulation between patients with brainstem stroke dysphagia and healthy adults by using functional near-infrared spectroscopy (fNIRS). Additionally, we seek to identify any potential relationship between cortical activity and swallowing.

METHODS

30 patients with dysphagia after brainstem stroke and 16 healthy adults were selected. The fNIRS was used to assess the functional connection strength of global and ROIs brain regions at rest, as well as the mean change in oxygenated hemoglobin concentration (ΔHbO2) during the food visual stimulation task in both groups.

RESULTS

In the resting state, the functional connection strength of healthy adults ([Formula: see text]) was higher than that of patients ([Formula: see text]) (P < 0.05). In comparison, functional connectivity in the ROI brain region was enhanced in the patient group compared to the healthy adult group. In the task state, the patient's ΔHbO2 concentration in the left Frontopolar area, right Frontopolar area, left Orbitofrontal area and left Dorsolateral prefrontal cortex dramatically decreased in comparison to the healthy adult group. The correlation analysis revealed a moderate negative correlation between SSA and the MMSE score, VAS score, and the average ΔHbO2 concentrations in specific brain regions, including the right Frontopolar area, left Frontopolar area, left Orbitofrontal area, and left DLPFC. Furthermore, the VAS scores exhibited a moderate positive correlation with the average ΔHbO2 concentrations in the right Frontopolar area, left Frontopolar area, left Orbitofrontal area, and left DLPFC.

CONCLUSION

Patients with brainstem stroke dysphagia showed reduced activity during visual stimulation in the Frontopolar region, the left Orbitofrontal area, and the left Dorsolateral prefrontal cortex as compared to healthy individuals. The overall strength of functional connections was decreased, while the ROI between different brain areas increased. Following a brain stem stroke, all of these might be related to pre-oral swallowing issues.

摘要

目的

运用功能近红外光谱技术（fNIRS），研究脑干卒中吞咽困难患者与健康成年人在食物视觉刺激下皮质活动的差异。此外，我们试图确定皮质活动与吞咽之间的潜在关系。

方法

选取30例脑干卒中后吞咽困难患者和16例健康成年人。使用fNIRS评估两组在静息状态下全脑及感兴趣区（ROIs）脑区的功能连接强度，以及在食物视觉刺激任务期间氧合血红蛋白浓度的平均变化（ΔHbO2）。

结果

在静息状态下，健康成年人的功能连接强度（[公式：见原文]）高于患者（[公式：见原文]）（P < 0.05）。相比之下，与健康成年人组相比，患者组ROI脑区的功能连接增强。在任务状态下，与健康成年人组相比，患者左侧额极区、右侧额极区、左侧眶额区和左侧背外侧前额叶皮质的ΔHbO2浓度显著降低。相关性分析显示，吞咽困难严重程度评估量表（SSA）与简易精神状态检查表（MMSE）评分、视觉模拟评分法（VAS）评分以及包括右侧额极区、左侧额极区、左侧眶额区和左侧背外侧前额叶皮质在内的特定脑区的平均ΔHbO2浓度之间存在中度负相关。此外，VAS评分与右侧额极区、左侧额极区、左侧眶额区和左侧背外侧前额叶皮质的平均ΔHbO2浓度呈中度正相关。