手掌局部振动对脑卒中后患者皮层活动的 影响：一项fNIRS研究

Effects of Focal Palm Vibration on Cortical Activity in Post-Stroke Patients: An fNIRS Study

摘要: 目的：运用功能性近红外光谱技术(functional near-infrared spectroscopy, fNIRS)，比较手掌局部振动(focal palm vibration, FPV)对健康受试者与脑卒中患者皮层活动响应的差异。方法：纳入14例健康受试者与22例脑卒中患者进行fNIRS检测，采样频率为11Hz。探头阵列按国际10/20标准布置，覆盖双侧前额叶皮层(prefrontal cortex, PFC)、前运动及辅助运动皮层(pre-motor and supplementary motor cortex, P-SMA)、初级运动皮层(primary motor cortex, M1)、初级躯体感觉皮层(primary somatosensory cortex, S1)及缘上回皮层(supramarginal gyrus, SMG)。采用Block范式，包括5个循环，每循环30秒FPV刺激任务与30秒静息。原始fNIRS数据经NirSpark软件预处理，包括伪影去除、光密度转换及滤波等，计算出平均氧合血红蛋白(HbO₂)浓度。经时间锁定、平均化处理，最终获得每个受试者在任务态和静息态下的各大脑皮层感兴趣区(region of interest, ROI)的平均HbO₂浓度。在组内，分别采用t检验比较分析任务态与静息态下各皮层ROI的HbO₂值差异，并对所得p值进行假发现率(false discovery rate, FDR)校正，同时计算偏侧指数(laterality index, LI)。结果：在健康受试者中，与静息状态相比，任务期间仅LS1的HbO₂浓度升高(p < 0.05)，其余皮层感兴趣区未见变化。在脑卒中患者中，任务态下双侧M1、S1、P-SMA、PFC和LSMG的HbO₂浓度均高于静息态(p < 0.05)，而RSMG未观察到变化。偏侧指数分析结果显示：健康受试者表现出显著的左侧运动皮层优势(LI = 0.319)，而脑卒中患者组则表现为双侧激活模式(LI = −0.0589)。结论：FPV作为一种无创性干预措施，可能通过促进皮层重组，从而改善神经生理功能。该疗法作为上肢康复治疗的重要辅助手段，具有一定的临床应用潜力。

Abstract: Objective: This paper aims to use functional near-infrared spectroscopy (fNIRS) to compare the cortical activity response to focal palm vibration (FPV) in healthy subjects and stroke patients. Methods: Fourteen healthy participants and 22 post-stroke patients underwent fNIRS assessment at a sampling frequency of 11 Hz. The probe array was arranged according to the international 10/20 system and covered the bilateral prefrontal cortex (PFC), pre-motor and supplementary motor cortex (P-SMA), primary motor cortex (M1), primary somatosensory cortex (S1), and supramarginal gyrus (SMG). A block-design paradigm was adopted, consisting of five cycles, each including 30 seconds of FPV stimulation followed by 30 seconds of rest. Raw fNIRS data were preprocessed using NirSpark software, including motion artifact removal, optical density conversion, and filtering, and mean oxyhemoglobin (HbO₂) concentrations were calculated. After time-locking and averaging, the mean HbO₂ concentration for each region of interest (ROI) was obtained during both task and resting states. Within-group analysis was performed using t-tests to compare the HbO₂ concentration differences between task and rest states, with FDR (false discovery rate) correction applied to the p-values. Additionally, the laterality index (LI) was calculated. Results: In healthy participants, compared with the resting state, HbO₂ concentration increased only in the left primary somatosensory cortex (LS1) during the task period (p < 0.05), while no significant changes were observed in the other cortical ROIs. In post-stroke patients, HbO₂ concentrations in the bilateral M1, S1, P-SMA, PFC, and left SMG were significantly higher during the task state than during rest (p < 0.05), whereas no significant change was found in the right SMG. Laterality index analysis showed that healthy participants exhibited a marked left-hemispheric motor cortical dominance (LI = 0.319), whereas the stroke group demonstrated a bilateral activation pattern (LI = −0.0589). Conclusion: FPV, as a non-invasive intervention, may promote cortical reorganization and improve neurophysiological function. As an important adjunct in upper limb rehabilitation, this therapy holds potential for clinical application.