Volumetric effects of motor cortex injury on recovery of ipsilesional dexterous movements
Volumetric effects of motor cortex injury on recovery of ipsilesional dexterous movements
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DOI：
10.1016/j.expneurol.2011.05.015
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发表时间：
2011-09-01
影响因子：
5.3
通讯作者：
Morecraft, Robert J.
中科院分区：
文献类型：
--
作者：
Darling, Warren G.;Pizzimenti, Marc A.;Morecraft, Robert J.
传统上，一侧大脑半球运动皮质的损伤与对侧上肢瘫痪有关，但最近的患者研究发现，双侧上肢都有缺陷。在非人类灵长类动物中，我们检验了这样的假设，即损伤后早期自发性上肢运动障碍的严重程度取决于额叶运动区灰质和白质损伤的体积。我们还假设，实质性的康复将伴随着最低限度的任务练习，而患侧肢体的恢复将与对侧肢体的恢复相关。使用两项运动测试评估损伤后3-12个月的粗大(伸展)和精细手运动功能。用定量组织学方法评估白质和灰质损伤的体积。损伤后早期运动能力的改变与白质损伤体积呈负相关，表明损伤越大，自发性手运动控制的下降越大。所有猴子在损伤后阶段都表现出自发性手运动技能的改善，达到技能的改善与总损伤体积呈正相关，表明损伤越大，自损性运动技能恢复越大。我们认为，损伤侧大脑半球减少的跨痂抑制可能在观察到的技能提高中起作用。我们的研究结果表明，仅限于额部运动区的损伤可能伴随着显著的自发性手运动恢复。在人类中，中风后不可避免地会出现更明显的自闭性运动障碍，部分原因可能是更广泛的皮质下白质和灰质损伤。(C)2011 Elsevier Inc.保留所有权利。
Damage to the motor cortex of one hemisphere has classically been associated with contralateral upper limb paresis, but recent patient studies have identified deficits in both upper limbs. In non-human primates, we tested the hypothesis that the severity of ipsilesional upper limb motor impairment in the early post-injury phase depends on the volume of gray and white matter damage of the motor areas of the frontal lobe. We also postulated that substantial recovery would accompany minimal task practice and that ipsilesional limb recovery would be correlated with recovery of the contralesional limb. Gross (reaching) and fine hand motor functions were assessed for 3-12 months post-injury using two motor tests. Volumes of white and gray matter lesions were assessed using quantitative histology. Early changes in post-lesion motor performance were inversely correlated with white matter lesion volume indicating that larger lesions produced greater decreases in ipsilesional hand movement control. All monkeys showed improvements in ipsilesional hand motor skill during the post-lesion period, with reaching skill improvements being positively correlated with total lesion volume indicating that larger lesions were associated with greater ipsilesional motor skill recovery. We suggest that reduced trans-callosal inhibition from the lesioned hemisphere may play a role in the observed skill improvements. Our findings show that significant ipsilesional hand motor recovery is likely to accompany injury limited to frontal motor areas. In humans, more pronounced ipsilesional motor deficits that invariably develop after stroke may, in part, be a consequence of more extensive subcortical white and gray matter damage. (C) 2011 Elsevier Inc. All rights reserved.