θ短阵快速脉冲重复经颅磁刺激干预脑梗死后偏瘫手恢复相关脑网络的机制研究

项目名称： θ短阵快速脉冲重复经颅磁刺激干预脑梗死后偏瘫手恢复相关脑网络的机制研究

项目编号： No.81500994

项目类型： 青年科学基金项目

立项/批准年度： 2016

项目学科： 医药、卫生

项目作者： 党超

作者单位： 中山大学

项目金额： 17.5万元

中文摘要： 偏瘫手是脑梗死后神经功能恢复的重大临床挑战，严重影响患者的生活自理能力。其发生与恢复的机制、预后指标尚不清楚。我们前期研究证实：脑梗死后远隔部位运动相关皮层体积变化对患者运动功能恢复起抑制或促进作用，健侧半球白质重塑也参与运动功能恢复。结合最新研究进展，我们推测运动皮层体积变化、非运动区白质重塑改变可能参与偏瘫手的发生及转归。偏瘫手改善可能与运动区皮层兴奋状态及相关神经网络的相互联系变化有关。国内外研究显示：非侵入性脑部刺激技术可以调节运动区皮层兴奋性并改善偏瘫症状。本项目将基于θ短阵快速脉冲（TBS）重复经颅磁刺激调节运动皮层兴奋性方案和脑网络模式识别技术，研究TBS干预偏瘫手的疗效和脑网络参数的动态改变过程，建立偏瘫手预后识别和干预的成熟方案。本研究将对深入阐明偏瘫手恢复过程中皮层兴奋性变化的神经网络机制有重要的意义，并最终建立基于脑网络技术指导不同类型偏瘫手康复的个体化TBS干预方案

中文关键词： 脑梗死；偏瘫手；θ短阵快速脉冲；脑网络；图论

英文摘要： Motor defect in upper-limbs, especially the hemiplegic hands are the most common defect after cerebral infarction. The hemiplegic hands significantly resulted in poor quality of life and became a major challenge for post stroke rehabilitation.Our previous studies released that, secondary gray matter changes occur in some specific motor-related cortex may inhibit or promote functional recovery after an acute subcortical cerebral infarct. Based on the bimodal balance–recovery model, we hypothesise that the interhemispheric balancing and functional recovery to the structural reserve spared by the lesion might contribute to recovery of hand and arm function.Noninvasive brain stimulation techniques can be used to modulate the excitability of intracortical neuronal circuits and improve hemiplegic upper limbs’ function. Based on the complex brain network analysis and theta burst stimulation (TBS) protocols for improving hemiplegic hands function after stroke, we investigate the effects of TBS on hemiplegic hands function improvement and the interhemispheric balancing by graph analyses used to quantify the topological properties of the constructed brain networks.Further more the graph analyses might suggest as a potential biomarker to distinguish different patients and be helpful to clarify early mechanisms of motor defect in upper-limbs after stroke and provide individualizated therapy for improving hemiplegic hands’ function.

英文关键词： Cerebral Infarction;Hemiplegic Hand ;Theta Burst Stimulation;Brain Network;Graph Theory