■日常生活活动(ADL)的损害是中风后康复的主要问题。上肢运动障碍,具体来说,与生活质量低有关。在目前的病例报告中,我们使用任务型和静息状态功能磁共振成像(fMRI)工具,研究了1例重度上肢运动障碍的慢性卒中后患者高压氧治疗(HBOT)诱导的运动康复的神经反应机制和功能重组.
我们研究了一名61岁的右撇子男性患者的运动任务fMRI激活和静息状态功能连接(rsFC),该患者患有右上肢偏瘫和身体虚弱,在他受到严重侮辱两年后,每天60个HBOT疗程的治疗前后。在基线和治疗结束时使用Fugl-Meyer评估(FMA)和手握最大自主收缩(MVC)评估运动功能。
■遵循HBOT,FMA评分从17(严重损害)提高到31(中度损害)。在涉及受影响的手的试验期间进行干预后,在补充运动皮质(SMA)和运动前皮质(PMA)两侧观察到fMRI激活增加.侧化指数(LI)从1降至0.63,表明对侧半球的募集。感兴趣的区域,ROI到ROI,分析显示,干预后半球间连通性增加(P=0.002),网络间连通性增加(z评分:0.35±0.21~0.41±0.21,P<0.0001).使用右SMA作为种子的基于种子到体素的rsFC分析显示与左后顶叶皮层的连通性增加,左侧初级体感皮层,和运动前皮层。
■这项研究为慢性卒中后患者HBOT诱导的大脑可塑性和功能改善提供了更多见解。
UNASSIGNED: Impairments in activities of daily living (ADL) are a major concern in post-stroke rehabilitation. Upper-limb motor impairments, specifically, have been correlated with low quality of life. In the current
case report, we used both task-based and resting state functional MRI (
fMRI) tools to investigate the neural response mechanisms and functional reorganization underlying hyperbaric oxygen therapy (HBOT)-induced motor rehabilitation in a chronic post-stroke patient suffering from severe upper-limb motor impairment.
UNASSIGNED: We studied motor task
fMRI activation and resting-state functional connectivity (rsFC) in a 61-year-old right-handed male patient who suffered hemiparesis and physical weakness in the right upper limb, 2 years after his acute insult, pre- and post-treatment of 60 daily HBOT sessions. Motor functions were assessed at baseline and at the end of the treatment using the Fugl-Meyer assessment (FMA) and the handgrip maximum voluntary contraction (MVC).
UNASSIGNED: Following HBOT, the FMA score improved from 17 (severe impairment) to 31 (moderate impairment). Following the intervention during trials involving the affected hand, there was an observed increase in
fMRI activation in both the supplementary motor cortex (SMA) and the premotor cortex (PMA) bilaterally. The lateralization index (LI) decreased from 1 to 0.63, demonstrating the recruitment of the contralesional hemisphere. The region of interest, ROI-to-ROI, analysis revealed increased post-intervention inter-hemispheric connectivity (P = 0.002) and a between-network connectivity increase (z-score: 0.35 ± 0.21 to 0.41 ± 0.21, P < 0.0001). Seed-to-voxel-based rsFC analysis using the right SMA as seed showed increased connectivity to the left posterior parietal cortex, the left primary somatosensory cortex, and the premotor cortex.
UNASSIGNED: This study provides additional insights into HBOT-induced brain plasticity and functional improvement in chronic post-stroke patients.