近红外脑功能成像在脊髓性肌萎缩症患儿静息态脑功能网络中的研究

doi:10.12114/j.issn.1007-9572.2025.0261

中国全科医学 ›› 2026, Vol. 29 ›› Issue (14): 1867-1872.DOI: 10.12114/j.issn.1007-9572.2025.0261

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近红外脑功能成像在脊髓性肌萎缩症患儿静息态脑功能网络中的研究

牛国辉¹^,^*(), 屈楠楠¹, 张晓莉², 张萌萌¹, 王豆豆¹, 王鑫¹, 朱登纳¹

1．450052　河南省郑州市，郑州大学第三附属医院康复医学科
2．450052　河南省郑州市，郑州大学第三附属医院小儿神经内科

收稿日期:2025-06-10 修回日期:2025-10-25 出版日期:2026-05-15 发布日期:2026-04-14
通讯作者: 牛国辉
作者贡献：
牛国辉负责研究设计、指导，经费支持，对论文负责；屈楠楠负责研究实施，数据采集、整理及统计分析，文章撰写；张晓莉负责研究指导，论文修改；张萌萌、王豆豆、王鑫负责数据采集、整理；朱登纳负责数据分析、论文指导及修改。
基金资助:
河南省重点研发与推广专项(232102310135)

Study on Resting-state Brain Functional Networks in Children with Spinal Muscular Atrophy Based on Functional Near-infrared Spectroscopy

NIU Guohui¹^,^*(), QU Nannan¹, ZHANG Xiaoli², ZHANG Mengmeng¹, WANG Doudou¹, WANG Xin¹, ZHU Dengna¹

1. Department of Rehabilitation Medicine, the Third Affiliated Hospital of Zhengzhou University, Zhengzhou 450052, China
2. Department of Pediatric Neurology, the Third Affiliated Hospital of Zhengzhou University, Zhengzhou 450052, China

Received:2025-06-10 Revised:2025-10-25 Published:2026-05-15 Online:2026-04-14
Contact: NIU Guohui

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摘要/Abstract

摘要： 背景脊髓性肌萎缩症（SMA）患儿的运动功能障碍是由脊髓前角运动神经元的退化引起的，研究表明脊髓损伤后脑结构和脑功能均发生了可塑性改变，因此推测SMA患儿的脑网络也可能发生改变，了解SMA患儿大脑的功能特征可以为康复治疗提供更多的数据支持。目的利用近红外脑功能成像（fNIRS）技术研究静息状态下SMA患儿脑功能网络的特点。方法选取2024年1—7月入住郑州大学第三附属医院康复医学科进行康复治疗的5~10岁SMA 2型患儿为研究对象（SMA组，n=23），同期自愿参加本研究的5~10岁健康儿童为对照（对照组，n=23）。应用fNIRS技术对SMA组和对照组在静息状态时的双侧额极、背外侧前额叶、颞叶、Broca区及运动区的脑氧合信号进行记录。采用独立样本t检验比较两组儿童功能连接矩阵及全局效率、局部效率、节点效率、节点局部效率、聚类系数等网络度量。结果 SMA组患儿大脑功能连接强于对照组（t=4.996，P<0.001），且主要位于颞叶及背外侧前额叶。在全局指标特性方面，SMA组和对照组的全局效率比较，差异无统计学意义（t=1.688，P>0.05）；SMA组的局部效率高于对照组（t=2.189，P=0.037）。节点指标特性方面，SMA组的节点效率在前运动区和辅助运动区大于对照组（t=2.266，P=0.031），聚类系数（t=2.177，P=0.038）及节点局部效率（t=2.187，P=0.037）在额极区大于对照组。结论 SMA患儿静息态脑网络功能连接增强，且SMA患儿可能存在涉及多个脑区重组的代偿机制。

关键词: 脊髓性肌萎缩症, 近红外脑功能成像, 功能性连接, 重组, 神经可塑性

Abstract:

Background

Motor dysfunction in children with spinal muscular atrophy (SMA) results from degeneration of anterior horn motor neurons. Prior research has demonstrated that spinal cord injury induces plastic changes in both brain structure and function. Based on this, it is hypothesized that children with SMA may also exhibit reorganization within brain networks. Understanding the functional features of the brain in children with SMA may offer additional data support for rehabilitation therapy.

Objective

To investigate resting-state brain network characteristics in children with SMA using functional near-infrared spectroscopy (fNIRS).

Methods

Children aged 5-10 years with SMA type 2 who were admitted to the Department of Rehabilitation Medicine of the Third Affiliated Hospital of Zhengzhou University from January to July 2024 were enrolled as the SMA group (n=23). Age-matched healthy children who volunteered during the same period were recruited as the control group (n=23). fNIRS was used to record cerebral oxygenation signals from the bilateral frontal poles, dorsolateral prefrontal cortex (DLPFC), temporal lobes, Broca's area, and motor cortex at rest. Independent-samples t-tests were applied to compare group differences in functional connectivity matrices and graph-theoretical network metrics including global efficiency, local efficiency, nodal efficiency, nodal local efficiency, and clustering coefficient.

Results

The SMA group exhibited stronger functional connectivity than the control group (t=4.996, P<0.001), primarily located in the temporal lobe and DLPFC. Regarding global network metrics, no significant difference in global efficiency was found between the SMA and control groups (t=1.688, P>0.05). However, local efficiency was significantly higher in the SMA group compared with control group (t=2.189, P=0.037). For nodal metrics, the SMA group showed greater nodal efficiency in the primary motor cortex and supplementary motor area compared with the control group (t=2.266, P=0.031). Additionally, both the clustering coefficient (t=2.177, P=0.038) and nodal local efficiency (t=2.187, P=0.037) were significantly higher in the frontopolar cortex compared with the control group.

Conclusion

Children with SMA exhibite enhanced functional connectivity within the resting-state brain network, and they may have a compensatory mechanism involving reorganization of multiple brain regions.

Key words: Spinal muscular atrophy, Functional near-infrared spectroscopy, Functional connectivity, Reorganization, Neuroplasticity

中图分类号:

R 746.4

牛国辉,屈楠楠,张晓莉,等. 近红外脑功能成像在脊髓性肌萎缩症患儿静息态脑功能网络中的研究[J]. 中国全科医学, 2026, 29(14): 1867-1872. DOI: 10.12114/j.issn.1007-9572.2025.0261.
NIU Guohui,QU Nannan,ZHANG Xiaoli, et al. Study on Resting-state Brain Functional Networks in Children with Spinal Muscular Atrophy Based on Functional Near-infrared Spectroscopy[J]. Chinese General Practice, 2026, 29(14): 1867-1872. DOI: 10.12114/j.issn.1007-9572.2025.0261.

图/表 5

图1 近红外脑功能成像通道位置图注：图中数字编号分别对应44个通道，不同颜色通道代表覆盖的不同脑区：蓝色（左：19~20，22~27/右：35~36，38~40，42~44）代表前运动区和辅助运动区；紫色（左：14，18，21/右：34，37，41）代表颞叶皮质；红色（左：11，12，15/右：29，30，33）Broca区；绿色（左：1，4，5，8/右：3，6，7，10）代表额极区（前额叶最前端）；黄色（左：13，16/右：28，32）代表背外侧前额叶皮质。

Figure 1 Location map of fNIRS channels

表1 SMA组与对照组一般资料比较

Table 1 Comparison of general information between SMA group and the control group

组别	例数	性别[例（%）]		年龄（±s，岁）	身高（±s，cm）	体质量（±s，kg）
组别	例数	男	女	年龄（±s，岁）	身高（±s，cm）	体质量（±s，kg）
SMA组	23	12（52.2）	11（47.8）	6.9±1.3	117.8±10.5	21.3±4.7
对照组	23	13（56.5）	10（43.5）	7.6±1.4	120.4±8.3	22.1±2.9
t（χ²）值		0.088^a		1.764	0.934	0.647
P值		0.767		0.085	0.355	0.521

图2 SMA组和对照组脑网络功能连接的差异注：A表示SMA组功能连接矩阵，B表示对照组功能连接矩阵，C表示SMA组整体连接的特征路径长度圈图，D表示对照组整体连接的特征路径长度圈图。

Figure 2 Differences in brain network functional connectivity between the SMA group and the control group

表2 SMA组与对照组全局指标比较（±s）

Table 2 Comparison of global metrics between the SMA group and the control group

组别	例数	全局效率	局部效率
对照组	23	0.28±0.13	0.46±0.14
SMA组	23	0.37±0.16	0.58±0.16
t值		1.688	2.189
P值		0.102	0.037

表3 SMA组与对照组节点指标比较（±s）

Table 3 Comparison of node metrics between the SMA group and the control group

组别	例数	前运动区和辅助运动区节点效率	额极皮质
组别	例数	前运动区和辅助运动区节点效率	聚类系数	节点局部效率
对照组	23	0.33±0.14	0.47±0.18	0.57±0.21
SMA组	23	0.46±0.18	0.60±0.13	0.72±0.16
t值		2.266	2.177	2.187
P值		0.031	0.038	0.037

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近红外脑功能成像在脊髓性肌萎缩症患儿静息态脑功能网络中的研究

Study on Resting-state Brain Functional Networks in Children with Spinal Muscular Atrophy Based on Functional Near-infrared Spectroscopy

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