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Neuroimaging technique is a kind of significant means to explore the mechanism of cerebral plasticity after stroke. Diffusion tensor imaging can be used to describe the structure of white matter fiber bundles and evaluate the degree of damage, but it cannot reflect the functional connections between different brain regions. Task-state functional magnetic resonance (fMRI) can detect the activation of corresponding brain regions caused by specific tasks, but the test design is complex and demanding for subjects. Resting-state fMRI can analyze complex brain networks and reflect functional connections in different brain regions, but the method of data analysis is complex. Functional near-infrared spectroscopy (fNIRS) is another non-invasive method to reflect the functional activation of brain regions, in which temporal resolution is better than fMRI, but the spatial resolution is slightly lower. The combination of multiple detection methods may be an important research direction in the future.
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Objective:To explore the differences in plasticity mechanism of cortical structure between hemispheres during rehabilitation for stroke patients at subacute stage. Methods:From October 20, 2018 to February 1, 2020, 22 patients with first-onset subcortical ischemic stroke completed the assessments of MRI and clinical evaluation at admission, and after one and two months of rehabilitation. Cortical surface area, thickness, and volume were measured to evaluate cortical structure plasticity. Two-way repeated measures analyses of variance were implemented to estimate dynamic cortical morphology changes and differences between hemispheres. Results:A significant time effect occurred between admission and after one month of rehabilitation for both hemispheres. Cortical surface area, thickness and volume for most regions in both hemispheres gradually decreased, while parahippocampal gyrus thickness and volume increased. The surface area and volume of postcentral gyrus was significant between both hemispheres (F > 4.305, P < 0.05), in which ipsilesional hemisphere was lower than contralesional hemisphere. The reduction of the thickness (r = -0.474, P = 0.026) and volume (r = -0.432, P = 0.044) of postcentral gyrus in ipsilesional hemisphere was negatively correlated with the recovery rate of motor function. Conclusion:There are differences in cortical structure plasticity during stroke rehabilitation between hemispheres. Cortical morphology markedly changes in the first two months poststroke. The greater the reduction in thickness and volume of postcentral gyrus in ipsilesional hemisphere is, the worse the recovery of motor function may be.
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Objective:To explore the features and rehabilitation of Pusher syndrome (PS). Methods:A female patient was reported and the literatures were reviewed. Results:The patient presented moderate ipsilateral, deep sensory disturbance, left spatial neglect and disuse. White matter degeneration was found. After four-week rehabilitation, the score of Scale for Contraversive Pushing decreased from 2.5 to 0.75, and her hand function recovered to assistant hand. Conclusion:The degeneration of white matter develops rapidly in PS patient, while the recovery of motor function is relatively slow, and need longer and comprehensive rehabilitation, especially the exercise therapy and somatosensory stimulation.
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Objective:To apply functional near-infrared spectroscopy (fNIRS) to analyze brain activity pattern of bilateral sensorimotor cortex (SMC) and premotor cortex (PMC) during complex dominant and non-dominant hand movement in healthy subjects. Methods:From August to December, 2019, 15 right-handed healthy residents were recruited. The block designed grip-release task was used in the subjects, and detected oxyhemoglobin and deoxyhemoglobin concentration with fNIRS to analyze the activation of bilateral SMC, PMC and prefontal cortex in term of activation channels and intensity. Results:For the oxyhemoglobin concentration, the number of activated channels was the same in both hemispheres during right (dominant) hand movement, and the activation of left SMC was stronger (P < 0.05); however, more channels were activated in the right hemisphere during left (non-dominant) hand movement, and the activation of right SMC was stronger (P < 0.05). For the deoxyhemoglobin concentration, more channels were activated in the contralateral hemisphere during either dominant or non-dominant hand movement, and the activation of left SMC, Channel 12 (left PMC) and Channel 26 (right PMC) were stronger during right (dominant) hand movement (P < 0.05). Conclusion:It is feasible to use fNIRS to study the activation of hand movement related brain regions during complex movement of dominant and non-dominant hand, especially with the results of oxyhemoglobin concentration.
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Objective:To observe the effects of transcranial direct current stimulation (tDCS) on the naming of visual and auditory modality in patients with post-stroke aphasia. Methods:From March to November, 2018, 32 patients with post-stroke aphasia were randomly divided into control group (n = 16) and treatment group (n = 16). The treatment group accepted anodal-tDCS (A-tDCS) over left-inferior frontal gyrus (L-IFG) concurrent with speech training, while the control group accepted sham-tDCS. Before and two weeks after treatment, they were assessed with Western Aphasia Battery (WAB), Picture Naming Test and Environmental Sound Naming Test. Results:One patient was lost in the control group. After treatment, Aphasia Quotient of WAB improved in both groups (t > 5.081, P < 0.001), but the difference before and after treatment was not significantly different between two groups (t = 1.550, P > 0.05); the Picture Naming Test score improved in both groups (Z > 2.650, P < 0.01), and the difference before and after treatment was more in the treatment group than in the control group (Z = -2.258, P < 0.05); the object naming score of WAB improved in the treatment group (Z = -3.239, P < 0.01), and the difference before and after treatment was more in the treatment group than in the control group (Z = -3.008, P < 0.01); the score of Environment Sound Naming Test improved in the treatment group (t = -4.745, P < 0.001), and the difference before and after treatment was more in the treatment group than in the control group (t = 2.224, P < 0.05). The scores of spontaneous naming, sentences complement and reaction naming of WAB improved in the treatment group (Z > 2.191, P < 0.05), while the score of spontaneous naming of WAB improved in the control group (Z = -2.376, P < 0.05), but the differences before and after treatment were not significantly different between two groups (Z < 1.568, P > 0.05). Conclusion:A-tDCS over L-IFG may improve the naming ability of visual and auditory modality, which may associate with semantic or phonetic processing.
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Objective:To observe the effects of transcranial direct current stimulation (tDCS) on the naming of visual and auditory modality in patients with post-stroke aphasia. Methods:From March to November, 2018, 32 patients with post-stroke aphasia were randomly divided into control group (n = 16) and treatment group (n = 16). The treatment group accepted anodal-tDCS (A-tDCS) over left-inferior frontal gyrus (L-IFG) concurrent with speech training, while the control group accepted sham-tDCS. Before and two weeks after treatment, they were assessed with Western Aphasia Battery (WAB), Picture Naming Test and Environmental Sound Naming Test. Results:One patient was lost in the control group. After treatment, Aphasia Quotient of WAB improved in both groups (t > 5.081, P < 0.001), but the difference before and after treatment was not significantly different between two groups (t = 1.550, P > 0.05); the Picture Naming Test score improved in both groups (Z > 2.650, P < 0.01), and the difference before and after treatment was more in the treatment group than in the control group (Z = -2.258, P < 0.05); the object naming score of WAB improved in the treatment group (Z = -3.239, P < 0.01), and the difference before and after treatment was more in the treatment group than in the control group (Z = -3.008, P < 0.01); the score of Environment Sound Naming Test improved in the treatment group (t = -4.745, P < 0.001), and the difference before and after treatment was more in the treatment group than in the control group (t = 2.224, P < 0.05). The scores of spontaneous naming, sentences complement and reaction naming of WAB improved in the treatment group (Z > 2.191, P < 0.05), while the score of spontaneous naming of WAB improved in the control group (Z = -2.376, P < 0.05), but the differences before and after treatment were not significantly different between two groups (Z < 1.568, P > 0.05). Conclusion:A-tDCS over L-IFG may improve the naming ability of visual and auditory modality, which may associate with semantic or phonetic processing.
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Objective To explore the training mode of teachers for rehabilitation residents standardized training.Methods A total of more than 300 directors and key teachers of rehabilitation standardized residents training bases from all over China, who participated in the seminars and key teacher training courses, were investigated.Results The teachers came from most provinces, who were senior teachers. The average score of the base teaching director seminar was 92.6, and it was 88.5 for the key teacher training class. The training content that they desired in the future included teaching methods and teaching skills, teaching ward rounding, training experience sharing, scientific research ability training, rehabilitation evaluation meeting, rehabilitation Three-Basic training, national residents standardized training policy and management, graduation assessment design, rehabilitation base standard and humanistic education.Conclusion The content and methods of training for rehabilitation base teachers for rehabilitation residents standardized training need to be further improved.
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Objective To observe the change of the relative concentration of oxygenated hemoglobin in the frontal cortex during cognitive processing in patients with post-stroke depression (PSD), and to discuss the neural mechanism and changes of working memory function of PSD preliminarily. Methods From February to August,2017,20 patients with PSD(PSD group)and 20 patients with non-depressive(con-trol group)were recruited.NIRSport portable functional near-infrared spectroscopy system was used to observe the change of the relative concentration of hemoglobin in the frontal cortex during the emotional face gender judgment task and"1-back"working memory task. Results Compared with the control group,the change of the relative concentration of oxygenated hemoglobin in the pre-frontal cortex was significantly lower after the negative emotion faces were presented in PSD group(t=3.872,P<0.001).In the implementation of the"1-back",the change of the relative concentration of oxygenated hemoglo-bin in the left prefrontal cortex was significantly lower in PSD group than in the control group(t=2.475,P<0.05), however,there was no significant difference in the change in the right prefrontal cortex between two groups(t=1.773,P=0.084). Conclusion The prefrontal cortex activity decrease in patients with PSD after the negative emotion faces were present-ed.The left prefrontal working memory function is impaired.The patients with PSD have disorder of oxygen me-tabolism in the prefrontal lobe.