行政院國家科學委員會補助專題研究計畫成果報告:以功能性磁振造影及數位化腦波研究半球性中風之橫貫大腦半球之跨越性功能障礙

Abstract

本研究應用量化腦波及磁振造影的技 術，來研究中風後橫貫半球之跨越性功能 障礙的現象。由於此種現象是一種功能障 礙，我們將重點放在功能上的測量。 病人在急性期（中風72 小時內）及亞 急性期(中風2-3 週後)各接受一次評估與 檢查。評估的量表包括加拿大神經學量 表，在亞急性期再加上巴氏指標之評量。 磁振影像包括結構影像與及功能性影 像。量化腦波一共記錄2 次，結果針對各 大腦半球跨頻譜(Crossspectral)連貫性 (Coherence)分析研究。 總結：由於功能性磁振造影的敏感度 與特異性在本研究中皆不理想。量化腦波 的大腦半球跨頻譜(Crossspectral)連貫性 (Coherence)分析研究，則顯示了橫貫半球 之跨越性功能障礙的現象。

In this study we applied techniques of Quantitative EEG (qEEG) and MRI on the study of diaschisis after stroke. Since diaschisis indicates a remote change in functional status. Therefore, studies capable of measuring functional activities were adopted. We examined patients at acute stage (within 72hours after stroke) and at subacute stage (after 14 to 21 days). The patients were also assessed with the Canadian Neurological Scale (CNS) in the acute stage and the CNS and Barthel index at the subacute stage. Structural MRI was the used to define the area and the extent of the stroke. Functional MRI acquired from GRE-EPI pulse sequence. The results from fMRI studies were not sensitive and specific enough for delineating phenomenon. On the other hand, the qEEG study based on crossspectral coherence analysis revealed the diaschisis effect and its evolution over time, from acute to subacute stage.