[考试]康复干预可出现中枢性吞咽功能障碍时神经功能中枢代偿性重组现象
康复干预可出现中枢性吞咽功能障碍时神经功能中枢代偿性重组现象
目前,对于大脑吞咽功能中枢损伤后的可塑性机制仍然不是很清楚。来自中国河北联合大学的元小冬教授所在研究团队,应用血氧水平依赖脑功能性成像技术观察了脑梗死导致的中枢性吞咽功能障碍患者在给予吞咽活动刺激任务时,激活脑相关皮质中枢区域的功能影像学特征,发现中枢性吞咽障碍患者前扣带回等吞咽活动启动中枢的激活明显减弱,而且急性脑病变同侧吞咽活动相关中枢的激活强度也明显降低,但急性脑病变对侧吞咽相关中枢的激活强度无明显变化,同时出现后扣带回、前额叶、视、听皮质及小脑等中枢区域激活明显增强的现象,说明中枢性吞咽功能障碍患者出现了神经功能中枢代偿性重组现象。这提示在进行康复治疗时,可以给予患者以往喜欢的食物通过视觉和听觉等神经传导途径对其吞咽活动相关进行刺激,从而促进皮质中枢功能的代偿性重组,从而提高康复治疗效果。相关文献发
于《中国神经再生研究(英文版)》杂志2015年3月第3期。
右侧脑梗死导致的中枢性吞咽功能障碍患者在给予吞咽活动刺激任务时其右侧BA4区被激活,但是激活体积小于正常志愿者
Article: " Compensatory recombination phenomena of neurological functions in central dysphagia patients," by Xiao-dong Yuan1, Li-fu Zhou1, Shu-juan Wang1, Yan-sheng Zhao2, Xiao-jie Wang1, Li-li Zhang1, Shou-hong Wang2, Ya-jie
Zhang2, Li Chen2 (1 Department of Neurology, Affliated Kailuan General Hospital of Hebei United University, Tangshan, Hebei
Province, China; 2 Department of MRI Room, Affliated Kailuan General Hospital of Hebei United University, Tangshan, Hebei Province, China)
Yuan XD, Zhou LF, Wang SJ, Zhao YS, Wang XJ, Zhang LL, Wang SH, Zhang YJ, Chen L (2015) Compensatory recombination phenomena of neurological functions in central dysphagia patients. Neural Regen Res 10(3):490-497.
欲获更多资讯:请与《中国神经再生研究(英文版)》杂志国际发展部联络;联络电话:+8613804998773,或用电子邮件联络:eic@nrren.org 。 文章全文请见:
Compensatory recombination phenomena of neurofunctions in central dysphagia patients
The mechanism underlying the plasticity of the swallowing function after central dysphagia remains poorly understood. Xiao-dong Yuan, Affiliated Kailuan General Hospital of Hebei United University, China and his colleagues observed the functional imaging features of cerebral cortex in central dysphagia patients by using blood oxygen level-dependent functional magnetic resonance imaging techniques. They found that when recurrent cerebral infarction patients with central dysphagia swallowed, the degree of activation in the anterior cingulate cortex was decreased, but the activation intensity on the unaffected side was not obviously changed. Additionally, more areas were activated, including posterior cingulate cortex, visual association cortex, primary auditory cortex, parahippocampal cortex, somatosensory association cortex and the left cerebellum. These findings suggest that patients with recurrent cerebral infarction with central dysphagia show compensatory recombination phenomena of neurological functions. Thus, in rehabilitative treatment, using patient’s favorite food to stimulate the swallowing function through visual, auditory, and
other nerve conduction pathways can promote the compensatory recombination of the central cortex functions.
When performing swallowing, the right BA4 region was activated, but the activation volume was smaller in patients with right cerebral infarction and swallowing dysfunction than in healthy controls.
Article: " Compensatory recombination phenomena of neurological functions in central dysphagia patients,"
by Xiao-dong Yuan1, Li-fu Zhou1, Shu-juan Wang1, Yan-sheng Zhao2, Xiao-jie Wang1, Li-li Zhang1, Shou-hong Wang2, Ya-jie
Zhang2, Li Chen2 (1 Department of Neurology, Affliated Kailuan General Hospital of Hebei United University, Tangshan, Hebei
Province, China; 2 Department of MRI Room, Affliated Kailuan General Hospital of Hebei United University, Tangshan, Hebei Province,
China)
Yuan XD, Zhou LF, Wang SJ, Zhao YS, Wang XJ, Zhang LL, Wang SH, Zhang YJ, Chen L (2015) Compensatory recombination phenomena of neurological
functions in central dysphagia patients. Neural Regen Res 10(3):490-497.
Contact: Meng Zhao
eic@nrren.org
86-1380-4998-773
Neural Regeneration Research
cortical reactions evoked by swallowing activity may be abnormal in patients with central infarction with dysphagia
Numerous studies showed that central dysphagia caused by stroke and other diseases was an important factor of affecting the quality of life of patients and producing lung infections and other complications, but its clinical rehabilitation treatment methods and effects is uncertain, clinical study showed that there was a big difference in the effect of rehabilitation treatment between different patients.Currently, the mechanism of neural function reorganization between plasticity and central cortical areas of the brain after swallowing center injury is still not very clear. However, the study of swallowing related center damage characteristics and plasticity mechanism of reorganization compensatory of brain function will make us further understand the central regulatory mechanism of swallowing activities. It has an great significance for development of clinical individualized rehabilitation programs for central dysphagia patients and improvement of effect of rehabilitation treatment. Using fMRI technology, Xiaodong Yuan and his colleagues researched the functional imaging features of activation related cortical center when central dysphagia patients caused by cerebral infarction were stimulated by swallowing activities. They found that activation of former callosal gyrus, the start center of swallowing, significantly reduced in patients with central dysphagia, and activation intensity of swallowing related center in ipsilateral brain lesions also significantly reduced. However, activation intensity of swallowing related center in contralateral acute brain lesions had no significant changes, but activation intensity in rear callosal gyrus, prefrontal, visual and auditory cortex and cerebellum was significantly enhanced. It suggested neurological central reorganization compensatory phenomenon appeared in central dysphagia patients. This indicated that central dysphagia patients were given their favorite food through nerve pathway of visual and auditory to stimulate their swallowing activities, it would promote reorganization compensatory of central cortex to improve effect of rehabilitation treatment. Thereby, it could make a guidance for us to develop individualized rehabilitation programs for central dysphagia patients using this method in clinical.