中文摘要：

目的 采用fMRI纵向观察脑梗死患者双手握拳运动时脑功能区的动态重组和代偿情况,并探讨其与运动功能恢复水平的关系。方法 34例脑梗死患者（病例组）及16名正常人（正常对照组）分别进行双手的握拳运动,进行实时BOLD-fMRI,病例组在发病1周内（早期）首次扫描,其中11例患者5~7周（恢复期）再次接受扫描,正常对照组只扫描1次。应用SPM8软件测定初级运动皮层（M1）激活体积,计算偏侧化指数（LI）及Fugl-Meyer Assessment（FMA）运动积分,分析LI与FMA积分在早期和恢复期的变化。结果 早期患手运动激活双侧M1、次级运动皮层,恢复期主要激活对侧M1、次级运动皮层,同侧脑激活区减少;脑梗死患者LI与FMA值在早期与恢复期差异均有统计学意义（P均〈0.05）。患者健侧肢体运动的脑激活模式与正常人相似。结论 BOLD-fMRI可显示梗死患者脑皮层运动代表区的动态重塑过程,可为脑梗死治疗康复提供重要基础和方法。

英文摘要：

Objective To dynamicly observe the compensation process of motor cortex function of ischemic stroke pa- tients with paralyses with fMRI, and to probe relationship of brain activation and movement restoration. Methods Totally 34 stroke patients （patient group） and 16 normal health volunteers （normal group） respectively performed clenching of both hands, and scans were synchronous with movement. The normal group were examined only once, and post stroke symptom onset less than one week （early stage） of 34 patients in patient group who underwent the first fMRI and 5--7 weeks （recovery stage） after stroke of 11 patients in patient group underwent fMRI again. Primary motor area activations were presented in SPM8. Differences of laterality index （LI） and Fugl-Meyer movement function scores between early stage and recovery stage were analyzed statistically. Results During early stage, bilateral primary and secondary motor cortex activated when paralyzed side performed movements. During recovery stage, contra-lateral motor region activations increased while ipsilateral activations area reduced. Differences of LI and Fugl-Meyer movement function scores were significant between early stage and recovery stage （P~0.05）. Brain activation patterns in patients with normal contralateral limb movements were similar with normal health volunteers. Conclusion fMRI can be used to dynamicly observe reorganization and compensation processes of brain cortex, and provide significant basis and method for the treatent and rehabilitation of cere- bral infarction.