中風患者抓握動作功能性磁振造影研究文獻回顧

Cortical Reorganization during Grasping Tasks in Stroke Patients: A Literature Review of fMRI studies

劉佩怡(Pei-Yi Liu) ； 謝富翰(Fu-Han Hsieh) ； 黃百川(Pai-Chuan Huang)

《臺灣職能治療研究與實務雜誌》 9卷1期 (2013/06) Pp. 52-74

https://doi.org/10.6534/jtotrp.2013.9(1).52

摘要

目的：抓握動作的功能性磁振造影可提供中風病患大腦皮質可塑性具體證據，然而目前相關文獻對於動作任務的執行以及中風個案招募標準的差異較大。本文目的在整理相關實證研究，供日後設計中風個案磁振造影任務之參考。方法：以Medline、PubMed等文獻搜尋引擎，涵蓋年代為2001至2011年，文獻需符合：受試者包含中風個案、使用的評估工具包含fMRI、執行的任務包含抓握。結果：抓握動作的磁振造影無特定對於中風時間、偏癱程度、受損腦區之限定，且可得到較明顯的BOLD訊號，有利於提升目標腦區定位的精確度。中風個案在執行患側手動作任務時有健側腦過度活化的現象，並且比健康成人活化較多運動相關的皮質區，且復原愈差的個案活化的位置愈多。結論：相較於其他磁振造影任務，抓握動作磁振造影可提供較高的適用範圍，可以提升腦區定位的精確性，能引發較明顯的腦區重塑，有助於磁振造影訊號的判讀與運動腦區的重塑。

關鍵字

腦中風 ； 抓握任務 ； 腦重組 ； 磁振造影

並列摘要

Objective: Functional magnetic resonance imaging of grasping tasks can provide substantial evidence of cortical reorganization in stroke patients, but the standards of motor task execution and the criteria of subject recruitment are diverse in recent studies. The purpose of this review is to summarize and analyze fMRI studies with grasping tasks in stroke patients to provide guidance for future studies. Methods: Two databases were searched for articles investigating cortical reorganization by functional MR imaging with grasping task from 2001 to 2011. Inclusion criteria were: subjects were hemiparetic; using fMRI as an evaluating tool; and including grasping task. Results: Studies of functional MR imaging of grasping task does not show specific limitation on time poststroke, hemiparetic severity, and lesion location. In addition, better BOLD signal can be obtained and the precision of target cortex locating can be improved. Most studies showed that stroke patients usually overactivated non-lesioned side cortices and activated more motor cortices than healthy people did during grasping task. Further, the worse the recovery situation, the more cortices were activated in stroke patients. Conclusion: Functional MR imaging with grasping task allowed wider range of application than other tasks, could improve the precision of cortex targeting, and could induce sharper cortical reorganization. The complexity of fMRI signal analysis could be reduced and improves the precision of diagnoses, and the effect of motor cortical reorganization could be enhanced and benefits motor functional recovery.

並列關鍵字

Stroke ； Grasping task ； Cortical reorganization ； Functional magnetic resonance imaging