Ipsilateral motor pathways after stroke: implications for non-invasive brain stimulation.
Ipsilateral motor pathways after stroke: implications for non-invasive brain stimulation.
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DOI：
10.3389/fnhum.2013.00184
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发表时间：
2013
影响因子：
2.9
通讯作者：
Byblow WD
中科院分区：
文献类型：
--
作者：
Bradnam LV;Stinear CM;Byblow WD
在人类中，两个大脑半球在控制上肢方面发挥着重要作用。本文的目的是提请注意同侧下行通路对卒中后功能恢复的潜在重要性，以及对侧初级运动皮层（M1）的无创脑刺激（NBS）方案的使用。传统上，NBS用于抑制对侧病灶M1，并减弱对同侧病灶M1的经胼胝体抑制。很少有人考虑到这样一个事实，即对侧M1抑制也可能降低同侧下行通路的兴奋性，这对某些患者的麻痹性上肢控制可能很重要。一种这样的同侧通路是皮质-网状-本体脊髓通路（CRPP）。在这篇综述中，我们概述了一个神经生理学模型来解释如何对侧病变M1可能获得控制的麻痹手臂通过CRPP。我们的结论是，在使用NBS抑制对侧病灶M1之前，必须考虑CRPP对个体患者运动控制的相对重要性。神经生理学，神经影像学和临床评估可以帮助这一决策，并促进NBS转化为临床环境。
In humans the two cerebral hemispheres have essential roles in controlling the upper limb. The purpose of this article is to draw attention to the potential importance of ipsilateral descending pathways for functional recovery after stroke, and the use of non-invasive brain stimulation (NBS) protocols of the contralesional primary motor cortex (M1). Conventionally NBS is used to suppress contralesional M1, and to attenuate transcallosal inhibition onto the ipsilesional M1. There has been little consideration of the fact that contralesional M1 suppression may also reduce excitability of ipsilateral descending pathways that may be important for paretic upper limb control for some patients. One such ipsilateral pathway is the cortico-reticulo-propriospinal pathway (CRPP). In this review we outline a neurophysiological model to explain how contralesional M1 may gain control of the paretic arm via the CRPP. We conclude that the relative importance of the CRPP for motor control in individual patients must be considered before using NBS to suppress contralesional M1. Neurophysiological, neuroimaging, and clinical assessments can assist this decision making and facilitate the translation of NBS into the clinical setting.
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影响因子：
1.7
作者：
Fregni, F;Boggio, PS;Pascual-Leone, A
通讯作者：
Pascual-Leone, A
影响因子：
8.3
作者：
Ackerley, Suzanne J.;Stinear, Cathy M.;Byblow, Winston D.
通讯作者：
Byblow, Winston D.
影响因子：
11.2
作者：
Ameli, Mitra;Grefkes, Christian;Nowak, Dennis A.
通讯作者：
Nowak, Dennis A.
影响因子：
2.5
作者：
Bradnam, Lynley V.;Stinear, Cathy M.;Byblow, Winston D.
通讯作者：
Byblow, Winston D.
影响因子：
2
作者：
ALSTERMARK, B;LUNDBERG, A;SASAKI, S
通讯作者：
SASAKI, S