Effects of limb immobilization on brain plasticity
Effects of limb immobilization on brain plasticity
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DOI：
10.1212/wnl.0b013e31823fcd9c
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发表时间：
2012-01-01
期刊：
影响因子：
9.9
通讯作者：
Jaencke, L.
中科院分区：
文献类型：
--
作者：
Langer, Nicolas;Haenggi, J.;Jaencke, L.
目的：人们对人脑感觉输入和运动输出减少的影响知之甚少。因此，我们进行了一项纵向研究，探讨单侧手臂损伤后的肢体固定是否反映在灰质（皮质厚度）和白质（分数各向异性[FA]）的结构塑性变化中。方法：我们检查了 10 名右上肢受伤且需要至少 14 天肢体固定的右手受试者。受试者接受了 2 次 MRI 检查，第一次是在受伤后 48 小时内，第二次是在平均固定时间间隔 16 天后。根据 MRI 扫描，我们测量了感觉运动区的皮质厚度和皮质脊髓束的 FA。 结果：固定后，我们发现左侧初级运动和躯体感觉区的皮质厚度减少，左侧皮质脊髓束的 FA 减少。此外，左手（未受伤）手的运动技能得到改善，并且与右运动皮层皮质厚度和 FA 的增加有关。结论：本研究表明，在右臂固定期间，感觉运动皮层的皮质厚度和皮质脊髓束的 FA 发生了变化，并且这些变化与从右手到左手的技能转移有关。因此，固定会导致感觉运动系统的快速重组。鉴于肢体固定是约束诱导治疗中的标准干预技术，治疗师应该意识到这种干预的积极和消极影响。神经病学（R）2012；78：182-188
Objective: Little is known about the effects of reduced sensory input and motor output in the human brain. Therefore, we conducted a longitudinal study to investigate whether limb immobilization after unilateral arm injury is reflected in structural plastic changes in gray matter (cortical thickness) and white matter (fractional anisotropy [FA]).Methods: We examined 10 right-handed subjects with injury of the right upper extremity that required at least 14 days of limb immobilization. Subjects underwent 2 MRI examinations, the first within 48 hours postinjury and the second after an average time interval of 16 days of immobilization. Based on the MRI scans, we measured cortical thickness of sensorimotor regions and FA of the corticospinal tracts.Results: After immobilization, we revealed a decrease in cortical thickness in the left primary motor and somatosensory area as well as a decrease in FA in the left corticospinal tract. In addition, the motor skill of the left (noninjured) hand improved and is related to increased cortical thickness and FA in the right motor cortex.Conclusions: The present study illustrates that cortical thickness of the sensorimotor cortex and FA of the corticospinal tract changed during right arm immobilization and that these changes are associated with skill transfer from the right to the left hand. Thus, immobilization induces rapid reorganization of the sensorimotor system. Given that limb immobilization is a standard intervention technique in constraint-induced therapy, therapists should be aware of both the positive and negative effects of this intervention. Neurology (R) 2012;78:182-188