脑中风患者脑功能重塑研究中应注意的问题

　　摘　要：大脑可塑性的研究是目前神经科学研究的前沿.PET和fMRI为在活体直观地研究脑功能重塑提供了有力武器,但在对脑功能研究中会遇到一些方法学的问题,本文从患者和对照组的选择、功能恢复的评价指标、运动模式的选择、脑形态变化对脑功能显像的影响、脑区激发结果的解释和PET功能图像分析方法的合理性等方面阐述所应注意的问题.
关键词：脑中风;脑重塑;正电子发射体层显像;功能磁共振成像
分类号：R44.52,R817.4　文献标识码：A
文章编号：1001-098X(2005)01-0001-05
 
　　作者单位：左传涛（200233,上海,复旦大学附属华山医院核医学科PET中心）　

　　参考文献：

　　[1]Bao S, Chan VT, Merzenich MM. Cortical remodelling induced by activity of ventral tegmental dopamine neurons[J]. Nature, 2001, 412 (6842): 79-83.
　　[2]Schoups A, Vogels R, Qian N. Practising orientation identification improves orientation coding in V1 neurons[J]. Nature, 2001, 412(6846): 549-553.
　　[3]Otte A. The plasticity of the brain[J]. Eur J Nucl Med, 2001, 28(3): 263-269.
　　[4]Curt A, Bruehlmeier M, Leenders KL, et al. Differential effect of spinal cord injury and functional impairment on human brain activation[J]. J Neurotrauma, 2002, 9(1): 43-51.
　　[5]Lee DS, Lee JS, Oh SH, et al. Deafness: Cross-R modal plasticity and cochlear implants[J]. Nature, 2 001,409(6817): 149-150.
　　[6]Nishimura H, Hashikawa K, Doi K, et al. Signlanguage"heard"in the auditory cortex[J]. Nature, 1999, 397 (6715): 116.
　　[7]Rauschecker JP. Compensatory plasticity and sensory substitution in the cerebral cortex[J]. Trends Neurosci, 1995, 18( 1 ): 36-43.
　　[8]Cohen LG, Celnik P, Pascual-Leone A, et al. Functional relevance ofcross-modal plasticity in blind humans[J]. Nature, 1997, 389 (6647): 180-183.
　　[9]Finney EM, Fine I, Dobkins KR. Visual stimuli activate auditory cortex in the deaf[J]. Nat Neurosci, 2001, 4(12): 1171-1173.
　　[10]王洪田,田嘉禾,尹大一,等.耳鸣相关脑区的正电子发射断层显像[J].中华耳鼻咽喉科杂志,2000,35(6):420-424.
　　[11]Karbe H, Herholz K, Halber M, et al. Collateral inhibition of transcallosal activity facilitates functional brain asymmetry[J]. J Cereb Blood Flow Metab, 1998, 18(10): 1157-1161.
　　[12]Calautti C, Serrati C, Baron JC. Effects of age on brain activation during auditory-cued thumb-to-index opposition: a positron emission tomography study[J]. Stroke, 2001, 32(1): 139-146.
　　[13]Shimizu T, Hosaki A, Hino T, et al. Motor cortical disinhibition in the unaffected hemisphere after unilateral cortical stroke[J]. Brain, 2002, 125(Pt 8): 1896-1907.
　　[14]Toga AW, Mazziotta JC. Brain Mapping: The Methods[M]. edn2.New York: Academic Press; 2002.
　　[15]Brett M, Leff AP, Rorden C, et al. Spatial normalizationof brain images with focal lesions using cost functionmasking[J]. Neuroimage,2001, 14(2): 486-500.
　　[16]Seto E, Sela G, McIlroy WE, et al. Quantifying head motionassociated with motor tasks used in fMRI[J]. Neuroimage, 2001, 14(2):284-297.
　　[17]Nelles G, Cramer SC, Schaechter JD, et al. Quantitative assessment of mirror movements after stroke[J]. Stroke, 1998, 29 (6): 1182-1187.
　　[18]Thomas KM, King SW, Franzen PL, et al. A developmentalfunc tional MRI study of spatial working memory[J]. Neuroimage, 1999,10 (3Pt 1): 327-338.
　　[19]Magistretti PJ, Pellerin L. Cellular mechanisms ofbrain energy metabolism and their relevance to functional brainimaging. Philos[J].Trans R Soc, 1999, 354( 1387): 1155-1163.
　　[20]Phillips WA, Singer W. In search of common foundationsfor cortical eomputation. Behav[J]. Brain Sci, 1997, 20(4): 657-683.
　　[21]Friston KJ, Ashburner J, Frith CD, et al. Spatial registration and normalization of images[J]. Human Brain Mapping, 1995, 2(2): 165-189.
　　[22]Kim YK, Lee DS, Lee SK, et al. (18)F-FDG PET in localization of frontal lobe epilepsy: comparison of visual and SPM analysis[J]. J Nucl Med, 2002, 43(9): 1167-1174.
　　[23]Kim YK, Lee DS, Lee SK, et al. Differential features of metabolic abnormalities between medial and lateral temporal lobe epilepsy: quantitative analysis of (18)F-FDG PET using SPM[J]. J Nucl Med,2003, 44(7): 1006-1012.
　　[24]Yang DW, Kim BS, Park JK, et al. Analysis of cerebral blood flow of subcortical vascular dementia with single photon emission computed tomography: adaptation of statistical parametric mapping[J]. J Neurol Sci, 2002, 11(15): 203-204.
　　[25]左传涛,林祥通,李殿友,等.晚期帕金森病患者脑内18F-FDG摄取变化及其异常脑内环路机制的探讨[J].中华核医学杂志,2004,24(2):107-109.
　　[26]李培勇,江旭峰,张立颖,等.强迫症患者局部脑血流变化的SPM分析和R0I分析[J].中华核医学杂志,2002,22(1):87-89.
　　[27]张剑戈,郭万华,李培勇,等.PET脑视功能区域自动提取的研究[J].上海第二医科大学学报,2003,23(1):24-27.