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投稿时间：2024-11-21 网络发布日期：2025-06-20
投稿时间：2024-11-21 网络发布日期：2025-06-20
中文摘要: 目的 通过功能性近红外光谱技术（fNIRS）探究卒中后认知障碍（PSCI）患者与健康成年人静息态脑功能连接（FC）的异同。方法 前瞻性随机抽取2023年7月至2024年8月于临沂市人民医院康复医学科住院治疗的40例PSCI患者，并向社会招募健康成人20例，利用fNIRS采集20例左侧脑卒中、20例右侧脑卒中患者和20例健康对照组5 min 的静息态额叶、顶叶和枕叶的血流动力学数据，并在14个感兴趣区（ROI）：左右侧背外侧前额叶皮质（DLPFC）、额极、左右侧眶额叶皮质（OFC）、左右侧布洛卡区（Broca）、左右侧初级感觉皮质（S1）、左右侧前运动区和运动辅助区（PMC/SMA）、左右侧初级运动皮质（M1）、枕叶皮质中比较三组间的FC强度差异。结果 以氧合血红蛋白为基础的分析结果证实，较健康对照组（0.46±0.18），左侧和右侧脑卒中组的大脑FC强度［（0.39±0.13）、（0.39±0.12）］的平均值有下降，但差异无统计学意义（P＞0.05）；同源ROI分析结果提示，左侧（L）脑卒中组L?M1、右侧（R）脑卒中组R?DLPFC的FC强度分别低于健康对照组（P＜0.05）。非同源ROI分析结果提示，左、右脑卒中组R?M1～L?M1间及R?PMC/SMA～L?M1间FC强度分别低于健康对照组（P＜0.05）；R?Bro?ca～L?Broca、R?S1～L?M1间FC强度，右脑卒中组低于健康对照组（P＜0.05），R?PMC/SMA～L?PMC/SMA间FC强度，左脑卒中组低于健康对照组（P＜0.05），差异均有统计学意义。结论 利用fNIRS的静息态脑FC研究发现，脑卒中组的全脑FC强度较健康对照组有所下降，但无统计学差异；半球内和半球间分析显示出FC强度变化的异质性，FC强度的降低部分地发生于左右脑卒中组的M1、S1、PMC/SMA和Broca区。
中文关键词: 功能性近红外光谱技术 认知障碍，卒中后 脑网络功能连接 半球内 半球间
Abstract:Objective To explore the similarities and differences of resting brain functional connectivity（FC）between patients with post-stroke cognitive impairment（PSCI）and healthy adults by functional near-infrared spectroscopy（fNIRS）.Methods A total of 40 PSCI patients hospitalized in the Rehabilitation Medicine Department of Linyi People’s Hospital from July 2023 to August 2024 and 20 healthy adults recruited from society were prospectively and randomly selected.fNIRS was used to detect the hemodynamic data of resting frontal lobe，parietal lobe and occipital lobe for 5 min in 20PSCI patients with left hemisphere stroke（LHS group），20 PSCI patients with right hemisphere stroke（RHS group）and20 healthy controls（control group）. The differences of FC intensity among the three groups were compared in 14 regions of interest （ROI），including left and right dorsolateral prefrontal cortex （DLPFC），frontal pole，left and right orbitofrontal cortex（OFC），left and right Broca’s area，left and right primary sensory cortex（S1），left and right premotor cortex and supplementary motor area（PMC/SMA），left and right primary motor cortex（M1），and occipital cortex. Results The results of oxyhemoglobin - based analysis confirmed that compared with the control group（0.46±0.18），the average value of brain FC intensity decreased in LHS group（0.39±0.13）and RHS group（0.39±0.12），but the difference was not statistically significant（P>0.05）. The results of homologous ROI analysis suggested that the FC intensity of L - M1 in LHS group and R - DLPFC in RHS group were lower compared to the healthy control group significantly（P<0.05）. The results of non-homologous ROI analysis indicated that the FC intensity of R-M1-to-L-M1 andR-PMC/SMA-to-L-M1 in LHS group and RHS group were lower compared to the control group significantly（P< 0.05）.The FC intensity of R-Broca-to-L-Broca and R-S1-to-L-M1 in RHS group were lower than those in control group（P<0.05）. The FC intensity of R-PMC/SMA-to-L-PMC/SMA in LHS group was lower compared to control group significantly（P<0.05）. Conclusion The research on resting -state brain FC using fNIRS shows that the whole brain FC intensity in the stroke groups is lower than that in the control group，but without significant statistical difference. Intra-hemispheric and inter- hemispheric analyses show that the heterogeneity of FC intensity changes，and the decrease of FC intensity occur partially in M1，S1，PMC/SMA and Broca areas of LHS and RHS groups.
keywords: Functional near ⁃infrared spectroscopy Cognitive impairment ,post ⁃ stroke Brain network functional connectivity Intra⁃hemisphere Inter⁃hemisphere
文章编号： 中图分类号：R493 R743.3 文献标志码：A
基金项目:山东省医药卫生科技项目（2023BJ000012）；临沂市重点研发计划（2023YX0042）
附件
| Author Name | Affiliation |
| WANG Xinyu*，LIU Yanling，LIU Jiaqi，GAO Yunhan，JIN Yan，ZHU Chongtian | *Linyi People’s Hospital Affiliated to Shandong Second Medical University，Linyi，Shandong 276000，China |
引用文本：
汪鑫煜,刘彦玲,刘佳琪,等.卒中后认知障碍患者脑网络功能连接的功能性近红外光谱技术研究[J].中国临床研究,2025,38(6):894-900.
汪鑫煜,刘彦玲,刘佳琪,等.卒中后认知障碍患者脑网络功能连接的功能性近红外光谱技术研究[J].中国临床研究,2025,38(6):894-900.