■这项研究的目的是利用功能近红外光谱（fNIRS）来鉴定由局灶性肌肉振动（FMV）引起的皮质活动的变化，直接给予偏瘫中风患者受影响的前臂屈肌。此外,该研究旨在研究这些变化与患者临床特征之间的相关性，从而扩大了对与这些效应相关的潜在神经生理机制的理解。
■本研究选择了22例因右侧偏瘫入院接受康复治疗的中风患者。使用块设计范例从受试者收集fNIRS数据。随后，使用NirSpark软件对收集的数据进行分析,以确定每个受试者在任务和休息状态下每个感兴趣皮质区域(ROI)的平均氧合血红蛋白(Hbo)浓度.刺激任务是FMV（频率60Hz，振幅6mm）直接应用于患侧的屈腕肌（FCR）的腹部。在大脑皮层的六个感兴趣区域（ROI）中测量Hbo，其中包括双侧前额叶皮质（PFC），感觉运动皮层（SMC），和枕骨皮质（OC）。同时评估患者的临床特征，包括Lovett的6级肌肉力量评估,临床肌张力评估，Fugl-Meyer评估(FMA-UE)的上肢功能项目，Bruunstrom分期量表（BRS），和修改后的Barthel指数（MBI）。进行统计分析以确定ROI中的激活并理解其与患者临床特征的相关性。
■统计分析显示，除了右OC，双边SMC的任务状态和休息状态的平均Hbo之间存在统计学上的显着差异，PFC,离开了OC。受累腕屈肌群肌力与Hbo(Hbo-CV)变化值呈正相关,以及左侧SMC中的β值，PFC,和OC。然而,在右侧SMC中，肌肉力量与Hbo-CV或β值之间没有发现统计学相关性，PFC,和OC。受影响的上肢的BRS与左侧SMC和PFC中的Hbo-CV或β值呈正相关。相比之下,在正确的SMC中没有观察到统计学相关性，PFC,双边OC。受累腕屈肌组肌张力无明显相关性,FMA-UE,MBI,和皮质ROI的Hbo-CV或β值。
■FMV诱发的感觉刺激直接应用于瘫痪侧的FCR腹部，激活了额外的大脑皮层，包括双侧PFC和同期OC，以及脑卒中患者的双侧SMC。然而,患者的临床特征仅与同损SMC和PFC激活的强度相关.本研究结果为FMV临床应用的拓展提供了神经生理学理论支持。
UNASSIGNED: The purpose of this study was to utilize functional near-infrared spectroscopy (fNIRS) to identify changes in cortical activity caused by focal muscle vibration (FMV), which was directly administered to the affected forearm flexor muscles of hemiplegic stroke patients. Additionally, the study aimed to investigate the correlation between these changes and the clinical characteristics of the patients, thereby expanding the understanding of potential neurophysiological mechanisms linked to these effects.
UNASSIGNED: Twenty-two stroke patients with right hemiplegia who were admitted to our ward for rehabilitation were selected for this study. The fNIRS data were collected from subjects using a block-design paradigm. Subsequently, the collected data were analyzed using the NirSpark software to determine the mean Oxyhemoglobin (Hbo) concentrations for each cortical region of interest (ROI) in the task and rest states for every subject. The stimulation task was FMV (frequency 60 Hz, amplitude 6 mm) directly applied to belly of the flexor carpi radialis muscle (FCR) on the affected side. Hbo was measured in six regions of interest (ROIs) in the cerebral cortex, which included the bilateral prefrontal cortex (PFC), sensorimotor cortex (SMC), and occipital cortex (OC). The clinical characteristics of the patients were assessed concurrently, including Lovett\'s 6-level muscle strength assessment, clinical muscle tone assessment, the upper extremity function items of the Fugl-Meyer Assessment (FMA-UE), Bruunstrom staging scale (BRS), and Modified Barthel index (MBI). Statistical analyses were conducted to determine the activation in the ROIs and to comprehend its correlation with the clinical characteristics of the patients.
UNASSIGNED: Statistical analysis revealed that, except for right OC, there were statistically significant differences between the mean Hbo in the task state and rest state for bilateral SMC, PFC, and left OC. A positive correlation was observed between the muscle strength of the affected wrist flexor group and the change values of Hbo (Hbo-CV), as well as the beta values in the left SMC, PFC, and OC. However, no statistical correlation was found between muscle strength and Hbo-CV or beta values in the right SMC, PFC, and OC. The BRS of the affected upper limb exhibited a positive correlation with the Hbo-CV or beta values in the left SMC and PFC. In contrast, no statistical correlation was observed in the right SMC, PFC, and bilateral OC. No significant correlation was found between the muscle tone of the affected wrist flexor group, FMA-UE, MBI, and Hbo-CV or beta values of cortical ROIs.
UNASSIGNED: FMV-evoked sensory stimulation applied directly to the FCR belly on the paralyzed side activated additional brain cortices, including bilateral PFC and ipsilesional OC, along with bilateral SMC in stroke patients. However, the clinical characteristics of the patients were only correlated with the intensity of ipsilesional SMC and PFC activation. The results of this study provide neurophysiological theoretical support for the expanded clinical application of FMV.
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