林可敬,董安琴,王鹤玮,等.卒中后认知障碍患者执行Go/No-Go任务时的脑功能特征的功能性近红外光谱成像研究[J].中华物理医学与康复杂志,2026,48(3):201-208
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| 卒中后认知障碍患者执行Go/No-Go任务时的脑功能特征的功能性近红外光谱成像研究 |
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| DOI：10.3760/cma.j.cn421666-20250616-00499 |
| 中文关键词: 卒中后认知障碍 抑制控制 脑激活 功能连接 功能性近红外光谱成像 |
| 英文关键词: Stroke Cognitive impairment Inhibitory control Brain activation Functional connectivity Functional near-infrared spectroscopy |
| 基金项目:河南省医学科技攻关计划省部共建重点项目 (SBGJ202402072)；河南省科技攻关项目 (252102310116) |
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| 中文摘要: |
| 目的 采用功能性近红外光谱成像技术 (fNIRS) 探究卒中后认知障碍 (PSCI) 患者在执行抑制控制任务 (Go/No-Go) 时前额叶及颞叶皮质的脑激活与功能连接 (FC) 特征。方法 选取 PSCI 患者和卒中后非认知障碍 (NPSCI) 患者各 20 例，将其分别纳入 PSCI 组和 NPSCI 组。采用 fNIRS 设备采集 2 组患者在执行 Go/No-Go 任务时其前额叶及颞叶皮质氧合血红蛋白 (HbO) 浓度变化数据。选择左、右两侧的额上回 (SFC)、颞上回 (STC)、背外侧前额叶 (DLPFC)、腹外侧前额叶 (VLPFC) 与内侧前额叶 (mPFC) 作为感兴趣脑区 (ROIs)，对比 2 组患者在执行抑制控制任务时各 ROI 脑区的激活水平、同源 / 异源 FC 强度及全局 FC 强度差异，并分析脑功能指标与蒙特利尔认知评估量表 (MoCA) 评分及 Go/No-Go 任务行为学表现的相关性。结果 行为学分析结果显示，PSCI 组患者在执行 Go/No-Go 任务时的正确率显著低于 NPSCI 组，反应时较 NPSCI 组显著增加（P<0.05），且 MoCA 评分与任务正确率具有正相关性（P<0.05），与反应时具有负相关性（P<0.05）。脑激活分析结果显示，PSCI 组患者在执行任务时其双侧 SFC、STC、VLPFC 及左侧 DLPFC 区的激活程度均显著低于 NPSCI 组（P<0.05）。FC 分析结果显示，PSCI 组在执行 Go/No-Go 任务时其 SFC 和 STC 的同源 FC 强度、分布于 SFC、STC 和 VLPFC 的 6 个 ROIs 脑区异源 FC 强度及全局 FC 强度均显著弱于 NPSCI 组（P<0.05）。通过相关性分析发现，PSCI 组前额叶和颞叶部分脑功能指标与 MoCA 评分及 Go/No-Go 正确率具有显著正相关性（P<0.05），与反应时具有显著负相关性（P<0.05）。结论 PSCI 患者在执行 Go/No-Go 任务时，其前额叶和颞叶皮质表现出激活程度、同源 FC、异源 FC 及全局 FC 强度均较 NPSCI 患者减弱，上述变化特征与患者认知功能及抑制控制能力具有显著相关性。 |
| 英文摘要: |
| Objective To explore prefrontal and temporal lobe activation and functional connectivity (FC) in persons with post-stroke cognitive impairment (PSCI) during a Go/No-Go task using functional near-infrared spectroscopy (fNIRS). Methods Twenty PSCI patients were selected into a PSCI group, while another 20 non-cognitive post-stroke impairment (NPSCI) patients were chosen into an NPSCI group. The changes in the concentration of oxygenated hemoglobin (HbO) in both groups' prefrontal and temporal cortices were collected using fNIRS while they performed a Go/No-Go task. The superior frontal gyrus (SFC)、superior temporal gyrus (STC)、dorsolateral prefrontal cortex (DLPFC)、ventrolateral prefrontal cortex (VLPFC), and medial prefrontal cortex on both the left and right sides were the regions of interest (ROIs). The differences in the activation of each ROI, in the intensity of homologous/heterologous functional connectivity (FC), and global FC intensity during the execution of the task were compared between the two groups. Those brain function indicators, Montreal Cognitive Assessment (MoCA) scores and Go/No-Go task performance were also correlated. Results Compared with the NPSCI group, the PSCI group had poorer accuracy and longer reaction times in the Go/No-Go task. The MoCA scores correlated positively with task accuracy but negatively with reaction time. On average, the PSCI patients showed less task-related activation in the bilateral SFC, STC, VLPFC and left DLPFC areas, weaker homotopic SFC/STC functioning, decreased heterotopic FC in 6 ROI pairs distributed among the bilateral SFC, STC and VLPFC, and lower global FC. However, relevant prefrontal-temporal brain function indices correlated positively with MoCA scores and task accuracy and negatively with reaction time. Conclusions PSCI patients exhibit decreased prefrontal-temporal activation, as well as homotopic, heterotopic and global FC during a Go/No-Go task, which correlate with cognitive functioning and inhibitory control. |
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