Two types of exercise-induced neuroplasticity in congenital hemiparesis: a transcranial magnetic stimulation, functional MRI, and magnetoencephalography study
Two types of exercise-induced neuroplasticity in congenital hemiparesis: a transcranial magnetic stimulation, functional MRI, and magnetoencephalography study
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DOI：
10.1111/dmcn.12209
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发表时间：
2013-10-01
影响因子：
3.8
通讯作者：
Mall, Volker
中科院分区：
文献类型：
--
作者：
Juenger, Hendrik;Kuhnke, Nicola;Mall, Volker
目的早期单侧脑损伤可导致对侧脑皮质脊髓投射持续存在，使对侧脑对瘫痪手进行运动控制。与初级运动表征（M1）相反，麻痹手的初级躯体感觉表征（S1）始终保留在受损半球。本研究旨在探讨具有同侧运动投射（ipsi）的个体与早期单侧损伤但健康的对侧运动投射（contra）的个体在运动诱导的神经可塑性方面的差异（对侧[Contra]组：n=7，4名女性，3名男性;年龄范围10- 30岁，中位年龄16岁;同侧[Ipsi]组：n=9，4名女性，5名男性;年龄范围11- 31岁，中位年龄12岁;两组中所有个体的手动能力分类系统I至II级）。受试者接受为期12天的强制性运动疗法（CIMT）干预，包括个人训练（2 h/d）和团体训练（8h/d）。在CIMT前后，使用Wolf运动功能测试（WMFT）测试手功能，并通过经颅磁刺激（TMS）、功能磁共振成像（fMRI）和脑磁图（MEG）观察不同的神经可塑性效应。使用非参数Wilcoxon符号秩检验进行TMS数据的统计分析，用于成对比较;对于fMRI，进行标准统计参数和非参数映射（SPM 5，SnPM 3）程序（第一级/第二级）。MEG数据的统计分析涉及方差分析（ANOVA）和t-test.Results虽然MEG表现出显着增加，在两组（p=0.012），TMS显示，在M1兴奋性Ipsi组（p=0.036），但在M1兴奋性增加的Contra组（p=0.043）。类似地，fMRI显示Ipsi组的M1激活减少，但Contra组的M1-S1区域激活增加（两组均为p
Aim Early unilateral brain lesions can lead to a persistence of ipsilateral corticospinal projections from the contralesional hemisphere, which can enable the contralesional hemisphere to exert motor control over the paretic hand. In contrast to the primary motor representation (M1), the primary somatosensory representation (S1) of the paretic hand always remains in the lesioned hemisphere. Here, we report on differences in exercise-induced neuroplasticity between individuals with such ipsilateral motor projections (ipsi) and individuals with early unilateral lesions but healthy' contralateral motor projections (contra).Method Sixteen children and young adults with congenital hemiparesis participated in the study (contralateral [Contra] group: n=7, four females, three males; age range 10-30y, median age 16y; ipsilateral [Ipsi] group: n=9, four females, five males; age range 11-31y, median age 12y; Manual Ability Classification System levels I to II in all individuals in both groups). The participants underwent a 12-day intervention of constraint-induced movement therapy (CIMT), consisting of individual training (2h/d) and group training (8h/d). Before and after CIMT, hand function was tested using the Wolf Motor Function Test (WMFT) and diverging neuroplastic effects were observed by transcranial magnetic stimulation (TMS), functional magnetic resonance imaging (fMRI), and magnetoencephalography (MEG). Statistical analysis of TMS data was performed using the non-parametric Wilcoxon signed-rank test for pair-wise comparison; for fMRI standard statistical parametric and non-parametric mapping (SPM5, SnPM3) procedures (first level/second level) were carried out. Statistical analyses of MEG data involved analyses of variance (ANOVA) and t-tests.Results While MEG demonstrated a significant increase in S1 activation in both groups (p=0.012), TMS showed a decrease in M1 excitability in the Ipsi group (p=0.036), but an increase in M1 excitability in the Contra group (p=0.043). Similarly, fMRI showed a decrease in M1 activation in the Ipsi group, but an increase in activation in the M1-S1 region in the Contra group (for both groups p