康復(fù)干預(yù)可出現(xiàn)中樞性吞咽功能障礙時(shí)神經(jīng)功能中樞代償性重組現(xiàn)象

1、康復(fù)干預(yù)可出現(xiàn)中樞性吞咽功能障礙時(shí)神經(jīng)功能中樞代償性重組現(xiàn)象目前，對于大腦吞咽功能中樞損傷后的可塑性機(jī)制仍然不是很清楚。來自中國河北聯(lián)合大學(xué)的元小冬教授所在研究團(tuán)隊(duì)，應(yīng)用血氧水平依賴腦功能性成像技術(shù)觀察了腦梗死導(dǎo)致的中樞性吞咽功能障礙患者在給予吞咽活動刺激任務(wù)時(shí)，激活腦相關(guān)皮質(zhì)中樞區(qū)域的功能影像學(xué)特征，發(fā)現(xiàn)中樞性吞咽障礙患者前扣帶回等吞咽活動啟動中樞的激活明顯減弱，而且急性腦病變同側(cè)吞咽活動相關(guān)中樞的激活強(qiáng)度也明顯降低，但急性腦病變對側(cè)吞咽相關(guān)中樞的激活強(qiáng)度無明顯變化，同時(shí)出現(xiàn)后扣帶回、前額葉、視、聽皮質(zhì)及小腦等中樞區(qū)域激活明顯增強(qiáng)的現(xiàn)象，說明中樞性吞咽功能障礙患者出現(xiàn)了神經(jīng)功能中樞代償性重組

2、現(xiàn)象。這提示在進(jìn)行康復(fù)治療時(shí)，可以給予患者以往喜歡的食物通過視覺和聽覺等神經(jīng)傳導(dǎo)途徑對其吞咽活動相關(guān)進(jìn)行刺激，從而促進(jìn)皮質(zhì)中樞功能的代償性重組，從而提高康復(fù)治療效果。相關(guān)文獻(xiàn)發(fā)表于中國神經(jīng)再生研究（英文版）雜志2015年3月第3期。右側(cè)腦梗死導(dǎo)致的中樞性吞咽功能障礙患者在給予吞咽活動刺激任務(wù)時(shí)其右側(cè)BA4區(qū)被激活，但是激活體積小于正常志愿者Article: " Compensatory recombination phenomena of neurological functions in central dysphagia patients," by Xiao-dong

3、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

4、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.欲獲更多資訊：請與中國神經(jīng)再生研究（

5、英文版）雜志國際發(fā)展部聯(lián)絡(luò)；聯(lián)絡(luò)電話：+8613804998773，或用電子郵件聯(lián)絡(luò)： 。 文章全文請見：/ Compensatory recombination phenomena of neurofunctions in central dysphagia patientsThe mechanism underlying the plasticity of the swallowing function after central dysphagia remains poorly understood. Xiao-don

6、g 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 recu

7、rrent 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,

8、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. Th

9、us, in rehabilitative treatment, using patients 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,

10、 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, Y

11、an-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,

12、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 Z86-1380-4998-773Neural Re

13、generation Research/cortical reactions evoked by swallowing activity may be abnormal in patients with central infarction with dysphagiaNumerous studies showed that central dysphagia caused by stroke and other diseases was an important factor of affecting the quality of life of

14、 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 f

15、unction 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 furt

16、her 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

17、 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 redu

18、ced 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