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机械性手指感觉刺激对中风后患者脑功能的影响:一项静息态功能磁共振成像研究。

Mechanical finger sensory stimulation effects on brain function in post-stroke patients: A resting-state fMRI study.

作者信息

Yao Kexin, Li Qiqi, Huang Wei, Xie Dongyan, Ma Yuqin, Zou Liwei, Hong Yongfeng

机构信息

The Department of Rehabilitation Medicine, The Second Affiliated Hospital of Anhui Medical University, Hefei, China.

The Department of Rehabilitation Medicine, Affiliated Hospital of West Anhui Health Vocational College, Lu 'an City, China.

出版信息

Brain Res. 2025 Oct 1;1864:149822. doi: 10.1016/j.brainres.2025.149822. Epub 2025 Jul 9.

Abstract

BACKGROUND AND PURPOSE

Stroke, as a common neurological disorder, often leads to varying degrees of upper limb motor dysfunction in patients. Mechanical digit sensory stimulation (MDSS), an emerging sensory intervention approach, has demonstrated potential in clinical settings for promoting motor function recovery. However, its underlying neural brain network mechanisms remain unclear. This study employs resting-state functional magnetic resonance imaging (rs-fMRI) combined with clinical functional assessment methods to investigate the effects of MDSS on improving limb motor function and activities of daily living in ischemic stroke patients during the recovery phase, and to elucidate the characteristic changes in brain functional network connectivity following MDSS intervention.

METHODS

The study included 60 patients in the recovery phase of post-stroke hemiplegia and implemented standardized MDSS on the fingernail bed of the affected side. The Fugl-Meyer Assessment (FMA) and the Modified Barthel Index (MBI) were used to evaluate motor function and activities of daily living, respectively. Resting-state functional connectivity (FC) and fractional amplitude of low-frequency fluctuations (fALFF) analyses were performed before and after the intervention.

RESULTS

After MDSS intervention, the patients showed significant improvements in both FMA total scores (P < 0.001) and MBI scores (P < 0.001). rs-fMRI analysis revealed a significant increase in fALFF values in the right postcentral gyrus, basal ganglia, and cerebellar regions (P < 0.05). Functional connectivity analysis further demonstrated enhanced connectivity in the sensorimotor network, cerebellar-cortical circuit, and frontoparietal integration pathway. Notably, the functional connectivity strength between the left cerebellar lobule VI and the right paracentral lobule showed a significant negative correlation with FMA scores (P < 0.05).

CONCLUSION

MDSS, as a non-invasive rehabilitation treatment, demonstrates good safety and effectively promotes motor function recovery in stroke patients during the recovery phase. Its mechanisms of action include enhancing functional connectivity in sensorimotor-related brain regions and suppressing abnormal compensation in non-motor areas, thereby optimizing neural resource redistribution. This study provides neurobiological evidence supporting MDSS as a standardized, safe, and effective adjunctive therapy for stroke rehabilitation.

摘要

背景与目的

中风作为一种常见的神经系统疾病,常导致患者出现不同程度的上肢运动功能障碍。机械性手指感觉刺激(MDSS)作为一种新兴的感觉干预方法,已在临床环境中显示出促进运动功能恢复的潜力。然而,其潜在的神经脑网络机制仍不清楚。本研究采用静息态功能磁共振成像(rs-fMRI)结合临床功能评估方法,探讨MDSS对改善缺血性中风患者恢复期肢体运动功能和日常生活活动能力的影响,并阐明MDSS干预后脑功能网络连接的特征性变化。

方法

本研究纳入60例中风后偏瘫恢复期患者,对患侧指甲床实施标准化的MDSS。分别采用Fugl-Meyer评估量表(FMA)和改良Barthel指数(MBI)评估运动功能和日常生活活动能力。在干预前后进行静息态功能连接(FC)和低频振幅分数(fALFF)分析。

结果

MDSS干预后,患者的FMA总分(P < 0.001)和MBI评分(P < 0.001)均有显著改善。rs-fMRI分析显示,右侧中央后回、基底神经节和小脑区域的fALFF值显著增加(P < 0.05)。功能连接分析进一步表明,感觉运动网络、小脑-皮质回路和额顶叶整合通路的连接增强。值得注意的是,左侧小脑小叶VI与右侧中央旁小叶之间的功能连接强度与FMA评分呈显著负相关(P < 0.05)。

结论

MDSS作为一种非侵入性康复治疗方法,具有良好的安全性,能有效促进中风患者恢复期的运动功能恢复。其作用机制包括增强感觉运动相关脑区的功能连接,抑制非运动区的异常代偿,从而优化神经资源再分配。本研究提供了神经生物学证据,支持MDSS作为中风康复的标准化、安全且有效的辅助治疗方法。

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