中国神经再生研究(英文版)

中国神经再生研究(英文版) ›› 2019, Vol. 14 ›› Issue (7): 1237-1246.doi: 10.4103/1673-5374.251331

• 原著:脑损伤修复保护与再生 • 上一篇    下一篇

单侧缺血性脑卒中患者定量脑电图分析：回顾性纵向观察性研究

  

  • 出版日期:2019-07-15 发布日期:2019-07-15

Longitudinal quantitative electroencephalographic study in mono-hemispheric stroke patients

Filippo Zappasodi 1 , Franca Tecchio 2 , Laura Marzetti 1 , Vittorio Pizzella 1 , Vincenzo Di Lazzaro 3 , Giovanni Assenza 3   

  1. 1 Department of Neuroscience, Imaging and Clinical Sciences and Institute for Advanced Biomedical Imaging, “G. D’Annunzio” University, Chieti, Italy
    2 Laboratory of Electrophysiology for Translational NeuroScience (LET’S), ISTC-CNR, and Fondazione Policlinico Gemelli IRCCS, Rome, Italy
    3 Unit of Neurology, Neurophysiology, Neurobiology, Department of Medicine, Università Campus Bio-Medico di Roma, Rome, Italy
  • Online:2019-07-15 Published:2019-07-15
  • Contact: Giovanni Assenza, MD, PhD, g.assenza@unicampus.it.
  • Supported by:

    FZ and FT obtained financial support from the Italian Ministry of Health Cod. GR-2008-1138642 “Promoting recovery from Stroke: individually  enriched therapeutic intervention in Acute phase”, and PNR-CNR Aging Program.

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摘要：

脑卒后临床恢复影响因素的确定对于个体化治疗干预是至关重要，其中因为电生理因素与脑卒中患者神经可塑性的增强直接相关。此次回顾性纵向观察性试验应用脑电图检测24例单侧大脑中动脉阻塞的急性期（症状发作后2-10天，T0）和亚急性期（2.5个月，T1）缺血性脑卒中患者的大脑神经元活性，并获得Higuchi分形维数；以美国国立卫生研究院卒中量表评估患者神经功能缺损严重程度。试验观察到，（1）损伤侧和对侧大脑半球δ和α频带脑电图信号功率在两个时间段之间发生了变化。（2）在T0，双侧大脑半球较高的δ频带功率与较差的临床条件相关（同侧：rs = 0.460，P = 0.027；对侧：rs = 0.508，P = 0.013）；而在T1，这种相关性仅在损伤侧大脑半球存在（rs = 0.411，P = 0.046）。（3）T0时患者α频带功率的双侧半球间差异明显在低于T1时。（4）T0时的Higuchi分形维数明显低于T1，并且在两个时间段，大脑损伤同侧Higuchi分形维数明显低于对侧。（5）这些数据表明，从急性期到亚急性期单侧大脑中动脉阻塞的缺血性脑卒中患者大脑半球间低频带不对称性和分形维度变化对临床恢复过程的神经可塑性敏感。试验于2011年7月14日经San Giovanni Calibita Fatebenefretelli医院伦理委员会批准(No. 40/2011)。

orcid: 0000-0002-6160-4348 (Giovanni Assenza)

关键词: 单侧大脑中动脉阻塞, delta频带, &alpha, 频带, 分形维数, 半球间不对称, 脑电图, 可塑性, 神经再生

Abstract:

The identification of individual factors modulating clinical recovery after a stroke is fundamental to personalize the therapeutic intervention to enhance the final clinical outcome. In this framework, electrophysiological factors are promising since are more directly related to neuroplasticity, which supports recovery in stroke patients, than neurovascular factors. In this retrospective observational study, we investigated brain neuronal activity assessed via spectral features and Higuchi’s fractal dimension (HFD) of electroencephalographic signals in acute phase (2–10 days from symptom onset, T0) and sub-acute phase (2.5 months, T1) in 24 patients affected by unilateral middle cerebral artery stroke. Longitudinal assessment of the clinical deficits was performed using the National Institutes of Health Stroke Scale (NIHSS), together with the effective recovery calculated as the ratio between difference of NIHSS at T0 and T1 over the NIHSS value at T0. We observed that delta and alpha band electroencephalographic signal power changed between the two phases in both the hemispheres ipsilateral (ILH) and contralateral (CHL) to the lesion. Moreover, at T0, bilateral higher delta band power correlated with worse clinical conditions (Spearman’s rs = 0.460, P = 0.027 for ILH and rs = 0.508, P = 0.013 for CLH), whereas at T1 this occurred only for delta power in ILH (rs = 0.411, P = 0.046) and not for CHL. Inter-hemispheric difference (ILH vs. CLH) of alpha power in patients was lower at T0 than at T1 (P = 0.020). HFD at T0 was lower than at T1 (P = 0.005), and at both phases, ILH HFD was lower than CLH HFD (P = 0.020). These data suggest that inter-hemispheric low band asymmetry and fractal dimension changes from the acute to the sub-acute phase are sensitive to neuroplasticity processes which subtend clinical recovery. The study protocol was approved by the Bioethical Committee of Ospedale San Giovanni Calibita Fatebenefretelli (No. 40/2011) on July 14, 2011.

Key words: mono-hemispheric stroke, delta band, fractal dimension, inter-hemispheric asymmetries, EEG, plasticity Chinese Library Classification No. R448, R741