A paradox: after stroke, the non-lesioned lower limb motor cortex may be maladaptive
A paradox: after stroke, the non-lesioned lower limb motor cortex may be maladaptive
复制标题
DOI：
10.1111/j.1460-9568.2010.07364.x
复制
发表时间：
2010-09-01
影响因子：
3.4
通讯作者：
Stinear, James W.
中科院分区：
文献类型：
--
作者：
Madhavan, Sangeetha;Rogers, Lynn M.;Stinear, James W.
是什么神经可塑性机制让一些中风患者重获高质量的控制，而另一些患者却不能？一种理论暗示同侧皮质脊髓通路从未损伤的半球投射出来。我们设计了一个新的经颅磁刺激方案，以确定同侧皮质脊髓束电导率，从非损伤半球到瘫肢体的慢性卒中患者。我们还通过弥散张量成像评估皮质脊髓束变性，并使用脚踝跟踪任务评估下肢运动控制。我们发现，在反相双侧踝关节运动中，从未损伤半球到麻痹性踝关节的导电性强的患者比导电性弱或无导电性的患者跟踪误差更大。这些发现表明，一些中风幸存者的非损伤半球对下肢运动控制的贡献可能是不适应的，而不是辅助运动控制。
What are the neuroplastic mechanisms that allow some stroke patients to regain high-quality control of their paretic leg, when others do not? One theory implicates ipsilateral corticospinal pathways projecting from the non-lesioned hemisphere. We devised a new transcranial magnetic stimulation protocol to identify ipsilateral corticospinal tract conductivity from the non-lesioned hemisphere to the paretic limb in chronic stroke patients. We also assessed corticospinal tract degeneration by diffusion tensor imaging, and used an ankle tracking task to assess lower limb motor control. We found greater tracking error during antiphase bilateral ankle movement for patients with strong conductivity from the non-lesioned hemisphere to the paretic ankle than for those with weak or no conductivity. These findings suggest that, instead of assisting motor control, contributions to lower limb motor control from the non-lesioned hemisphere of some stroke survivors may be maladaptive.