实时与视频动作观察疗法下脑卒中患者脑区血氧动力学反应比较:一项基于功能性近红外光谱的研究OA

Objective To investigate the hemodynamic differences in cortical activation during the observation-imitation process be-tween real-time action observation therapy(R-AOT)and video-based action observation therapy(V-AOT)in pa-tients with stroke using functional near-infrared spectroscopy(fNIRS). Methods A total of 29 patients with stroke in Shanxi Bethune Hospital from June to September,2025 were enrolled.A randomized-sequence,self-controlled crossover trial design was employed.Each participant received both R-AOT and V-AOT,with a one-day interval between the two conditions to minimize potential carryover effect.fNIRS was used to simultaneously record changes in oxyhemoglobin(Oxy-Hb)concentration during the observa-tion and imitation phases in regions of interest(ROIs),including the ipsilesional and contralesional dorsolateral prefrontal cortex(DLPFC),occipital cortex(OC),and temporal cortex(TC). Results After false discovery rate(FDR)correction across all ROIs,no significant difference was observed between R-AOT and V-AOT during either the observation or imitation phase(PFDR>0.05).During the observation phase,Oxy-Hb was greater under R-AOT than under V-AOT in the ipsilesional DLPFC(Z=2.183,PFDR=0.045).Oxy-Hb showed an opposite directional pattern between the two conditions in the ipsilesional OC,but the difference was not statistically significant(Z=2.321,PFDR=0.060).During the imitation phase,the ipsilesional TC showed greater Oxy-Hb changes under R-AOT than under V-AOT(Z=2.724,PFDR=0.018). Conclusion R-AOT and V-AOT may elicit different local cortical hemodynamic responses during the observation and imitation phases in patients with stroke.The between-condition difference during the observation phase was mainly observed in the ipsilesional DLPFC,whereas during the imitation phase it was mainly observed in the ip-silesional TC.