Development and reorganization of descending motor pathways in children with hemiplegic cerebral palsy
Development and reorganization of descending motor pathways in children with hemiplegic cerebral palsy
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DOI：
10.1111/j.1651-2227.1996.tb14278.x
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发表时间：
1996-10-01
期刊：
影响因子：
3.8
通讯作者：
Carr, LJ
中科院分区：
文献类型：
--
作者：
Carr, LJ
对33例偏瘫性脑瘫患者下行运动通路的重组进行了探讨。对受试者进行神经学评估，并从双手的同源肌肉中获取表面肌电图记录。功能性皮质脊髓投射是通过对运动皮质的局部磁刺激来评估的。在对照组中，这在短潜伏期内引起对侧手的肌电反应。在12名偏瘫受试者中，在对未受损的运动皮层进行刺激后，也看到了类似的结果。在其余22名受试者中，新的皮质脊髓通路出现在未受损的皮层，在那里刺激引起了双手的短潜伏期肌电图反应。通过两只手之间记录的肌电图进行的交叉相关分析显示，其中11名受试者出现了短时间的中心峰值，他们的手都有强烈的镜像运动。这些发现表明，两种模式的中枢重组可能遵循早期单侧皮质损伤。检查进一步表明，偏瘫患者的手功能可能与神经生理结果有关。
Reorganization of descending motor pathways was explored in 33 subjects with hemiplegic cerebral palsy. Subjects were assessed neurologically and surface electromyographic recordings were taken from homologous muscles of both hands. Functional corticospinal projections were assessed using focal magnetic stimulation of the motor cortex. In control subjects this evokes EMG responses in the contralateral hand at short latency. Similar results were seen in 12 of the hemiplegic subjects following stimulation of the undamaged motor cortex. In the remaining 22 subjects novel corticospinal pathways were demonstrated arising from the undamaged cortex, where stimulation evoked short latency EMG responses in both hands. Cross-correlation analysis performed from EMGs recorded between the two hands revealed short duration central peaks in 11 of these subjects, all of whom had strong mirror movements of the hands. These findings suggested that two patterns of central reorganization may follow early unilateral cortical insult. Examination further indicated that hand function in hemiplegic subjects could be related to the neurophysiological results.