Selective long-term reorganization of the corticospinal projection from the supplementary motor cortex following recovery from lateral motor cortex injury.
Selective long-term reorganization of the corticospinal projection from the supplementary motor cortex following recovery from lateral motor cortex injury.
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DOI：
10.1002/cne.22218
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发表时间：
2010-03-01
期刊：
影响因子：
--
通讯作者：
Morecraft RJ
中科院分区：
文献类型：
--
作者：
McNeal DW;Darling WG;Ge J;Stilwell-Morecraft KS;Solon KM;Hynes SM;Pizzimenti MA;Rotella DL;Vanadurongvan T;Morecraft RJ
影响额叶运动皮质或其下行轴突的脑损伤常引起对侧上肢轻瘫。虽然恢复是可变的，支持良好的运动恢复的潜在机制仍然不清楚。由于大脑半球的内侧壁往往是幸免于脑损伤后，最近的功能性神经影像学研究表明，在恢复过程中，这一脑区的潜在作用，我们调查了长期的影响孤立的外侧额叶运动皮质损伤的皮质脊髓投射（CSP）从完整的，同侧辅助运动皮质（M2）。受伤后的主要运动（M1）和外侧运动前区（LPMC）皮质的手臂区域，上肢恢复伴随着终端轴突可塑性在对侧CSP，但不是同侧CSP从M2。此外，显着的对侧可塑性只发生在第七层和背侧在第九层。因此，选择性的椎管内发芽发生在含有中间神经元，屈肌相关的运动神经元和运动神经元供应内在的手肌肉，都发挥重要作用，在调解达到和手指运动的区域。恢复后，M2的后续损伤导致手部运动缺陷的再次出现。考虑到CSP在人类中的重要性和外侧额叶皮层损伤的常见发生，这些研究结果表明，备用的补充运动皮层可能作为一个重要的治疗目标，应考虑设计急性和长期的损伤后患者干预策略，旨在提高运动恢复过程后外侧皮层创伤。
Brain injury affecting the frontal motor cortex or its descending axons often causes contralateral upper extremity paresis. Although recovery is variable, the underlying mechanisms supporting favorable motor recovery remain unclear. Since the medial wall of the cerebral hemisphere is often spared following brain injury and recent functional neuroimaging studies in patients indicate a potential role for this brain region in the recovery process, we investigated the long-term effects of isolated lateral frontal motor cortical injury on the corticospinal projection (CSP) from intact, ipsilesional supplementary motor cortex (M2). Following injury to the arm region of the primary motor (M1) and lateral premotor (LPMC) cortices, upper extremity recovery is accompanied by terminal axon plasticity in the contralateral CSP but not the ipsilateral CSP from M2. Furthermore, significant contralateral plasticity occurs only in lamina VII and dorsally within lamina IX. Thus, selective intraspinal sprouting transpires in regions containing interneurons, flexor-related motor neurons and motor neurons supplying intrinsic hand muscles which all play important roles in mediating reaching and digit movements. Following recovery, subsequent injury of M2 leads to reemergence of hand motor deficits. Considering the importance of the CSP in humans and the common occurrence of lateral frontal cortex injury, these findings suggest that spared supplementary motor cortex may serve as an important therapeutic target that should be considered when designing acute and long-term post-injury patient intervention strategies aimed to enhance the motor recovery process following lateral cortical trauma.
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8.3
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