中国神经再生研究(英文版)

中国神经再生研究(英文版) ›› 2023, Vol. 18 ›› Issue (2): 410-415.doi: 10.4103/1673-5374.344832

• 原著:脑损伤修复保护与再生 • 上一篇    下一篇

改良的约束诱导运动疗法干预脑创伤大鼠的大脑皮质可塑性

  

  • 出版日期:2023-02-15 发布日期:2022-08-09

Modified constraint-induced movement therapy enhances cortical plasticity in a rat model of traumatic brain injury: a resting-state functional MRI study

Cheng-Cheng Sun1, #, Yu-Wen Zhang2, #, Xiang-Xin Xing3, 4, 5, #, Qi Yang1, Ling-Yun Cao4, Yu-Feng Cheng4, Jing-Wang Zhao4, Shao-Ting Zhou6, Dan-Dan Cheng7, Ye Zhang8, Xu-Yun Hua3, 9, 10, *, He Wang2, 11, 12, *, Dong-Sheng Xu3, 4, 5, *   

  1. 1Department of Rehabilitation, Tongji Hospital, School of Medicine, Tongji University, Shanghai, China; 2Institute of Science and Technology for Brain-Inspired Intelligence, Fudan University, Shanghai, China; 3Center of Rehabilitation Medicine, Yueyang Hospital of Integrated Traditional Chinese and Western Medicine, Shanghai, China; 4Institute of Rehabilitation Medicine, School of Rehabilitation Science, Shanghai University of Traditional Chinese Medicine, Shanghai, China; 5Engineering Research Center of Traditional Chinese Medicine Intelligent Rehabilitation, Ministry of Education, Shanghai, China; 6Department of Rehabilitation, Shanghai East Hospital, School of Medicine, Tongji University, Shanghai, China; 7Department of Rehabilitation, Tongren Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China; 8Department of Rehabilitation, Shanghai Jiao Tong University Affiliated Sixth People’s Hospital, Shanghai, China; 9Department of Traumatology and Orthopedics, Yueyang Hospital, Shanghai University of Traditional Chinese Medicine, Shanghai, China; 10Department of Rehabilitation, Yangzhi Rehabilitation Hospital, Tongji University, Shanghai, China; 11Human Phenome Institute, Fudan University, Shanghai, China; 12Key Laboratory of Computational Neuroscience and Brain-Inspired Intelligence (Fudan University), Ministry of Education, Shanghai, China
  • Online:2023-02-15 Published:2022-08-09
  • Contact: Dong-Sheng Xu, MD, dxu0927@shutcm.edu.cn; He Wang, PhD, hewang@fudan.edu.cn; Xu-Yun Hua, MD, PhD, swrhxy@126.com.
  • Supported by:
    This project was supported by the National Key R&D Program of China, Nos. 2020YFC2004202 (to DSX), 2018YFC2001600 (to XYH); the National Natural Science Foundation of China, Nos. 81974358 (to DSX), 81802249 (to XYH) and 82172554 (to XYH).

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摘要：

改良的约束诱导运动疗法（mCIMT）在改善运动功能方面显示出有益的疗效，但确切的机制仍不清楚。实验通过静息态功能磁共振成像（rsfMRI）获得低频波动幅度（ALFF）指标，以研究改良的约束诱导运动疗法对模拟创伤性脑损伤的控制性左侧顶叶皮质撞击大鼠模型的运动功能和大脑皮质可塑性的影响。实验于伤后1周给予创伤性脑损伤大鼠为期3周的改良的约束诱导运动疗法（8h/d）干预。实验发现，在伤后3d，大鼠左侧运动皮质、体感皮质、岛状皮质和右侧运动皮质的平均ALFF信号下降，同时在右侧胼胝体中的平均ALFF信号增加。3周的改良的约束诱导运动疗法干预后，左侧胼胝体、左侧体感皮质、右侧内侧前额叶皮质、右侧运动皮质、左侧海马后背、左侧运动皮质、右侧大脑皮质的平均ALFF信号值明显增加。最后，实验通过Pearson相关分析显示，创伤性脑损伤大鼠上肢运动功能的改善与该脑区平均ALFF值的增加有关。实验结果（1）展示了脑损伤后大脑皮质功能可塑性变化，（2）证实改良的约束诱导运动疗法可通过增强双侧大脑半球皮质可塑性来改善创伤性脑损伤大鼠上肢运动功能，（3）提示平均ALFF值可作为潜在的生物标志物来评估创伤性脑损伤后与行为变化相关的大脑皮质的可塑性。

https://orcid.org/0000-0002-8477-5377 (Dong-Sheng Xu); https://orcid.org/0000-0002-2053-9439 (He Wang); https://orcid.org/0000-0002-2935-7551 (Xu-Yun Hua)

Abstract: Modified constraint-induced movement therapy (mCIMT) has shown beneficial effects on motor function improvement after brain injury, but the exact mechanism remains unclear. In this study, amplitude of low frequency fluctuation (ALFF) metrics measured by resting-state functional magnetic resonance imaging was obtained to investigate the efficacy and mechanism of mCIMT in a control cortical impact (CCI) rat model simulating traumatic brain injury. At 3 days after control cortical impact model establishment, we found that the mean ALFF (mALFF) signals were decreased in the left motor cortex, somatosensory cortex, insula cortex and the right motor cortex, and were increased in the right corpus callosum. After 3 weeks of an 8-hour daily mCIMT treatment, the mALFF values were significantly increased in the bilateral hemispheres compared with those at 3 days postoperatively. The mALFF signal values of left corpus callosum, left somatosensory cortex, right medial prefrontal cortex, right motor cortex, left postero dorsal hippocampus, left motor cortex, right corpus callosum, and right somatosensory cortex were increased in the mCIMT group compared with the control cortical impact group. Finally, we identified brain regions with significantly decreased mALFF values at 3 days postoperatively. Pearson correlation coefficients with the right forelimb sliding score indicated that the improvement in motor function of the affected upper limb was associated with an increase in mALFF values in these brain regions. Our findings suggest that functional cortical plasticity changes after brain injury, and that mCIMT is an effective method to improve affected upper limb motor function by promoting bilateral hemispheric cortical remodeling. mALFF values correlate with behavioral changes and can potentially be used as biomarkers to assess dynamic cortical plasticity after traumatic brain injury.

Key words: amplitude of low frequency fluctuation, cortical plasticity, functional magnetic resonance imaging, modified constraint-induced movement therapy, traumatic brain injury