Blood Oxygenation Level-Dependent Functional Magnetic Resonance Imaging: Correlation Between Passive Activation And Motor Recovery After Unilateral Striatocapsular Cerebral Infarction

Part I Comparison of the brain activation pattern between active and passive hand movement in healthy adultsObjective: BOLD-f MRI technique was used to explore the characteristics and patterns of activation of functional regions in healthy adults under active and passive tasks,to study the rehabilitation mechanism of severe hemiplegic limb after stroke.Methods: Fifteen healthy adult volunteers were selected as the subjects.The finger extension(FE)tasks were selected as the stimulus model,and the bilateral sensorimotor cortex(SMC)area,supplementary motor area(SMA)area and cerebellum were used as the region of interest(ROI).SPM8 and Xjview software were used for data processing and analysis.The T values and their coordinates,activation voxels and activation volume of the strongest activated voxels in the ROIs were calculated.Results: Under the active and passive exercise of the finger,the activation area of the brain in the healthy area was approximately the same,mainly in the contralateral sensorimotor area(c SMC area),the bilateral supplementary motor area(SMA area)and the ipsilateral cerebellum,The activation of the voxel value and activation cluster are larger.Conclusion: The activation pattern of the cortex under the active and passive motion tasks of finger is similar,suggesting that the passive FE task can be used as a substitute task for patients who can not perform active tasks.Part II Blood Oxygenation Level-Dependent FunctionalMagnetic Resonance Imaging in Early Days: Correlation between Passive Activation and Motor Recovery After Unilateral Striatocapsular Cerebral InfarctionObjective: This study aimed to investigate the correlation between the intracranial functional magnetic resonance imaging(f MRI)pattern and the motor function recovery of an affected limb during the passive movement of the affected limb at an early stage of the striatocapsular infarction(SCI).Methods: A total of 17 patients with an acute stage of SCI and 3 healthy volunteers as controls were included in this study.Blood oxygenation level–dependent(BOLD)-f MRI scans of passive movement were performed on the affected limbs of stroke patients within 1 week of onset.Follow-ups were carried out for the motor functions of the affected limbs(before f MRI scan,and 1 month and 3 months after the scan).Results: The control group showed that the expected activation was mainly located in the contralateral sensorimotor cortex(SMC)and the bilateral supplementary motor area(SMA).The f MRI scan regions of interest for stroke patients can be divided into three types: type I includes mainly the affected side,bilateral SMC,and SMA with activation;type II includes SMC on the affected side and SMA with activation;type III includes only SMC on the affected side or M1 with activation.Significant statistical differences were found in both the rate and the extent of motor function recovery of the affected limbs in patients with different types of activation.Conclusions: Multiple cortical activation patterns were noted during the passive movement of the affected limbs at an early stage of SCI,and a correlation was found between the different activation patterns and the clinical prognosis of patients.Part III The value of dynamic f MRI in the recovery of upper limb motor function after striatocapsular infarctionObjective: To study the dynamic changes of cortical functional reorganization in striatocapsular infarction by using the Bold-f MRI technique and its relationship with the recovery of motor function in the upper extremity of the hemiplegia.Try to build the dynamic model of intracranial functional reorganization in patients with striatocapsular infarction.Methods:A total of 17 patients with an acute stage of SCI and included in this study.At 1 month and 3 months after the onset of hemiplegia side finger passive FE task under the Bold-f MRI imaging,by SPM8 software to observe the activation of brain function in different periods of time.The brain activation region signals of Bold-f MRI were observed by Xjview software and compared with the dynamic state of brain activation.The upper limb part(FM-UL)of the Fugl-Meyer score was used to track the motor function of the upper limb.15 healthy volunteers were selected as the control group.Results: The control group showed that the activation was mainly located in the contralateral sensorimotor cortex(SMC)and the bilateral supplementary motor area(SMA).The f MRI scan region of interest for stroke patients can be divided into 3 types: type I includes mainly the affected side,bilateral SMC,and SMA with activation,1 month and 3 months Activation in the ipsilateral SMC region gradually increased;type II includes SMC on the affected side and SMA with activation,1 month when the performance of the side of the main side of the bilateral SMC area and SMA area was significantly activated,3 months when the patient activated SMC enhanced,ipsilateral weakened;type III includes only SMC or M1 on the affected side with activation,1 month when the ipsilateral SMC area activation increased slightly,3 months when the ipsilateral SMC area activation further enhanced,and with the standard brain activation area is roughly the same,SMA area no activation performance.The recovery of type I patients was better and faster,while the recovery of type II patients was better but slower,but recovery of type III patients was poorer and slower.Conclusion: Intracranial functional reorganization is a dynamic process.Early activation of ipsilateral SMC region can not predict clinical prognosis,but its overactivation is beneficial to clinical rehabilitation.The early activation of the contralateral hemisphere SMC region and the bilateral SMA region is of great significance in the stroke rehabilitation process.The contralateral hemisphere SMC region is related to the rate of recovery of motor function in patients.