不同病程脑卒中患者上肢体感诱发电位与感觉、运动功能的相关性

doi:10.3969/j.issn.1006-9771.2024.06.010

Abstract

Abstract:

Objective To investigate the correlation between somatosensory evoked potentials (SEP) of upper limbs, and sensory and motor functions in stroke patients in different stages.

Methods From June, 2021 to October, 2023, 177 stroke patients in Shijiazhuang People's Hospital were diveded into acute stage group (within 14 days, n = 25), early recovery group (14 days to one month, n = 110) and middle to late recovery group (one to six months, n = 42) according to the duration of the disease. General information of the patients was recorded; SEP examination was performed, and N20 lantency and amplitude were recorded. Monofilament touch and two-point discrimination sensation of the patient's hands were tested using the monofilament and two-point discrimination tools, respectively; and motor function was assessed with Fugl-Meyer Assessment-Upper Extremities (FMA-UE). The correlation between SEP, and the sensory and motor scores in each group was analyzed.

Results There was no significant difference in the monofilament tactile and two-point discrimination scores among the three groups (P > 0.05). SEP was not correlated with sensory and motor functions in the acute stage group (P > 0.05); in the early recovery group, N20 latency was negatively correlated with monofilament tactile sensation (r = -0.267, P = 0.005) and positively correlated with two-point discrimination sensation (r = 0.220, P = 0.021), and N20 amplitude was positively correlated with monofilament tactile sensation (r = 0.328, P < 0.001) and FMA-UE score (r = 0.418, P < 0.001), and negatively correlated with two-point discrimination (r = -0.405, P < 0.001); in the middle to late recovery group, the N20 latency was negatively correlated with FMA-UE score (r = -0.313, P = 0.044), and N20 amplitude was positively correlated with monofilament tactile sensation (r = 0.598, P < 0.001) and FMA-UE score (r = 0.393, P = 0.010), and negatively correlated with two-point discrimination (r = -0.591, P < 0.001). Multiple linear regression analyses showed that the score of monofilament tactile sensation was negatively correlated with N20 latency (β = -0.510, P = 0.046), and the FMA-UE score was positively correlated with N20 amplitude (β = 0.313, P = 0.026) in the middle to late recovery group; in the early recovery group, the two-point discriminative sensation score was negatively correlated with N20 amplitude (β = -0.270, P = 0.039).

Conclusion The correlation between SEP and sensory and motor functions becomes more significant with the prolongation of disease.

Key words: stroke, sensory function, motor function, somatosensory evoked potentials, neurophysiology

CLC Number:

R743.3

YANG Shining, MA Jiang, LI Hong, GUO Liying, LIU Xianying, ZHANG Lifang. Correlation of upper extremity somatosensory evoked potentials with sensory and motor functions in stroke patients in different stages[J]. Chinese Journal of Rehabilitation Theory and Practice, 2024, 30(6): 701-708.

Figures/Tables 6

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References 32

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组别	n	年龄/岁	病程/d	Brunnstrom手分期	Brunnstrom上肢分期
急性期组	25	56.68±13.86	12.00(9.50, 13.00)	1.00(1.00, 2.00)	1.00(1.00, 2.50)
恢复早期组	110	54.96±11.20	20.00(16.00, 25.00)	2.00(1.00, 4.00)	3.00(1.00, 4.00)
恢复中晚期组	42	53.98±12.49	60.50(48.75, 109.50)	3.00(1.00, 4.00)	3.00(2.00, 4.00)
F/H值		0.404^a	131.252^b	8.176^b	14.024^b
P值		0.668	< 0.001	0.017	0.001

组别	n	单丝触觉	两点辨别觉	FMA-UE
急性期组	25	5.00(1.50, 5.00)	8.00(6.00, 16.00)	6.00(4.50, 23.00)
恢复早期组	110	4.00(1.00, 5.00)	8.00(5.00, 16.00)	19.50(7.00, 40.50)
恢复中晚期组	42	4.00(0.00, 5.00)	8.50(5.00, 16.00)	17.00(8.00, 43.25)
H值		1.903	0.600	10.296
P值		0.386	0.741	0.006

组别	指标	N20潜伏期		N20振幅
组别	指标	r值	P值	r值	P值
急性期组	单丝触觉	-0.135	0.393	0.299	0.057
	两点辨别觉	0.121	0.443	-0.158	0.311
	FMA-UE评分	-0.103	0.491	-0.042	0.776
恢复早期组	单丝触觉	-0.267	0.005	0.328	< 0.001
	两点辨别觉	0.220	0.021	-0.405	< 0.001
	FMA-UE评分	-0.184	0.054	0.418	< 0.001
恢复中晚期组	单丝触觉	-0.119	0.453	0.598	< 0.001
	两点辨别觉	0.040	0.802	-0.591	< 0.001
	FMA-UE评分	-0.313	0.044	0.393	0.010

组别	指标	FMA-UE评分
组别	指标	r值	P值
急性期组	单丝触觉	-0.190	0.243
	两点辨别觉	-0.016	0.920
恢复早期组	单丝触觉	0.448	< 0.001
	两点辨别觉	-0.476	< 0.001
恢复中晚期组	单丝触觉	0.324	0.036
	两点辨别觉	-0.344	0.026

组别	指标	B	SE	β	t值	P值	容差	方差膨胀因子
急性期组	常量	20.082	1.702	-	11.797	< 0.001	-	-
	单丝触觉	-0.023	0.222	-0.029	-0.102	0.920	0.547	1.829
	两点辨别觉	0.079	0.089	0.250	0.889	0.384	0.556	1.800
	FMA-UE评分	-0.010	0.023	-0.090	-0.425	0.675	0.966	1.035
恢复早期组	常量	21.482	1.094	-	19.633	< 0.001	-	-
	单丝触觉	-0.187	0.146	-0.170	-1.283	0.202	0.492	2.032
	两点辨别觉	0.024	0.066	0.049	0.365	0.716	0.473	2.114
	FMA-UE评分	-0.017	0.013	-0.140	-1.323	0.189	0.770	1.299
恢复中晚期组	常量	23.892	1.607	-	14.863	< 0.001	-	-
	单丝触觉	-0.452	0.219	-0.510	-2.065	0.046	0.362	2.761
	两点辨别觉	-0.146	0.094	-0.385	-1.563	0.126	0.363	2.758
	FMA-UE评分	-0.021	0.015	-0.217	-1.364	0.180	0.869	1.151

Correlation of upper extremity somatosensory evoked potentials with sensory and motor functions in stroke patients in different stages

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组别	指标	B	SE	β	t值	P值	容差	方差膨胀因子
急性期组	常量	-0.672	2.102		-0.320	0.752
	单丝触觉	0.440	0.275	0.446	1.603	0.124	0.547	1.829
	两点辨别觉	0.109	0.110	0.274	0.995	0.331	0.556	1.800
	FMA-UE评分	0.017	0.028	0.126	0.601	0.555	0.966	1.035
恢复早期组	常量	3.903	1.335	-	2.924	0.004	-	-
	单丝触觉	0.084	0.178	0.060	0.475	0.636	0.492	2.032
	两点辨别觉	-0.168	0.080	-0.270	-2.095	0.039	0.473	2.114
	FMA-UE评分	0.023	0.016	0.152	1.500	0.137	0.770	1.299
恢复中晚期组	常量	2.066	1.347	-	1.534	0.133	-	-
	单丝触觉	0.167	0.183	0.190	0.909	0.369	0.362	2.761
	两点辨别觉	-0.106	0.078	-0.282	-1.353	0.184	0.363	2.758
	FMA-UE评分	0.030	0.013	0.313	2.321	0.026	0.869	1.151

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