中华物理医学与康复杂志
中華物理醫學與康複雜誌
중화물리의학여강복잡지
CHINESE JOURNAL OF PHYSICAL MEDICINE AND REHABILITATION
2015年
4期
262-265
,共4页
周立富%王淑娟%元小冬%赵艳生%张亚杰%马英%王卓%王小洁%孔元
週立富%王淑娟%元小鼕%趙豔生%張亞傑%馬英%王卓%王小潔%孔元
주립부%왕숙연%원소동%조염생%장아걸%마영%왕탁%왕소길%공원
吞咽%脑皮质中枢%偏侧性%调控%血氧水平依赖功能性磁共振成像
吞嚥%腦皮質中樞%偏側性%調控%血氧水平依賴功能性磁共振成像
탄인%뇌피질중추%편측성%조공%혈양수평의뢰공능성자공진성상
Swallowing%Cortical centers%Laterality%Control%BOLD-fMRI
目的 观察正常成人自主吞咽活动激活相关皮质中枢的分布情况及特征.方法 对10例正常右利手成人志愿者在执行吞咽任务时进行血氧水平依赖功能性磁共振成像(BOLD-fMRI)脑功能扫描,记录激活的皮质中枢体积及激活强度.结果 入选受试者执行吞咽任务时激活两侧BA4区体积有显著差异(P=0.04),而激活强度间无明显差异(P=0.20);激活两侧BA6/8区和BA24区的体积及强度均无明显差异(P＞0.05);激活两侧BA40区体积有明显差异(P=0.00),而激活强度间无明显差异(P=0.99);激活两侧BA32区体积有明显差异(P=0.00),而激活强度间无明显差异(P=0.87);激活两侧BA13区体积有明显差异(P=0.02),而激活强度间无明显差异(P=0.19).进一步分析发现,入选受试者执行吞咽任务时左侧半球激活体积明显大于右侧(P＜0.05),其偏侧性指数值(LI)为15.22％.结论 脑岛BA13区和前扣带皮质BA24/32区是正常成人自主吞咽功能的重要启动中枢,缘上回BA40区和BA6/8区是自主吞咽功能的重要运动规划中枢,而口咽部初级运动皮质中枢是其重要的运动执行中枢,同时这种自主吞咽运动功能的皮质中枢调控具有明显的优势半球偏侧性.
目的 觀察正常成人自主吞嚥活動激活相關皮質中樞的分佈情況及特徵.方法 對10例正常右利手成人誌願者在執行吞嚥任務時進行血氧水平依賴功能性磁共振成像(BOLD-fMRI)腦功能掃描,記錄激活的皮質中樞體積及激活彊度.結果 入選受試者執行吞嚥任務時激活兩側BA4區體積有顯著差異(P=0.04),而激活彊度間無明顯差異(P=0.20);激活兩側BA6/8區和BA24區的體積及彊度均無明顯差異(P＞0.05);激活兩側BA40區體積有明顯差異(P=0.00),而激活彊度間無明顯差異(P=0.99);激活兩側BA32區體積有明顯差異(P=0.00),而激活彊度間無明顯差異(P=0.87);激活兩側BA13區體積有明顯差異(P=0.02),而激活彊度間無明顯差異(P=0.19).進一步分析髮現,入選受試者執行吞嚥任務時左側半毬激活體積明顯大于右側(P＜0.05),其偏側性指數值(LI)為15.22％.結論 腦島BA13區和前釦帶皮質BA24/32區是正常成人自主吞嚥功能的重要啟動中樞,緣上迴BA40區和BA6/8區是自主吞嚥功能的重要運動規劃中樞,而口嚥部初級運動皮質中樞是其重要的運動執行中樞,同時這種自主吞嚥運動功能的皮質中樞調控具有明顯的優勢半毬偏側性.
목적 관찰정상성인자주탄인활동격활상관피질중추적분포정황급특정.방법 대10례정상우리수성인지원자재집행탄인임무시진행혈양수평의뢰공능성자공진성상(BOLD-fMRI)뇌공능소묘,기록격활적피질중추체적급격활강도.결과 입선수시자집행탄인임무시격활량측BA4구체적유현저차이(P=0.04),이격활강도간무명현차이(P=0.20);격활량측BA6/8구화BA24구적체적급강도균무명현차이(P＞0.05);격활량측BA40구체적유명현차이(P=0.00),이격활강도간무명현차이(P=0.99);격활량측BA32구체적유명현차이(P=0.00),이격활강도간무명현차이(P=0.87);격활량측BA13구체적유명현차이(P=0.02),이격활강도간무명현차이(P=0.19).진일보분석발현,입선수시자집행탄인임무시좌측반구격활체적명현대우우측(P＜0.05),기편측성지수치(LI)위15.22％.결론 뇌도BA13구화전구대피질BA24/32구시정상성인자주탄인공능적중요계동중추,연상회BA40구화BA6/8구시자주탄인공능적중요운동규화중추,이구인부초급운동피질중추시기중요적운동집행중추,동시저충자주탄인운동공능적피질중추조공구유명현적우세반구편측성.
Objective To investigate the distribution and characteristics of the central swallowing cortex in normal adults.Methods Blood-oxygen level dependent functional MRIs (BOLD-fMRIs) were recorded from 10 normal,right-handed volunteers during swallowing.The volume of the central cortex activated and the activation intensity were recorded.Results During the experiment there were significant differences in volume but not in intensity between the BA4,BA40,BA32 and BA13 areas activated on the two sides.No significant differences were observed in either the volume or the intensity of the activated BA6/8 and BA24 areas.Moreover,significantly more areas in the left hemisphere were activated when swallowing than in the right hemisphere,with the laterality index value being 15.22％.Conclusion Normal adults' volitional swallowing is triggered in the BA13 area of the insula and the BA24/32 area of the anterior cingulate cortex.It is planned in the BA40 area of the supramarginal gyrus and the BA6 and 8 areas and implemented in the primary motor cortex of the pharynx oralis.One hemisphere clearly dominates in the cortical control of volitional swallowing.
