Pilot study of functional MRI to assess cerebral activation of motor function after poststroke hemiparesis
Pilot study of functional MRI to assess cerebral activation of motor function after poststroke hemiparesis
复制标题
DOI：
10.1161/01.str.29.1.112
复制
发表时间：
1998-01-01
期刊：
影响因子：
8.3
通讯作者：
Welch, KMA
中科院分区：
文献类型：
--
作者：
Cao, Y;D'Olhaberriague, L;Welch, KMA
背景目的目的-缺血性卒中后运动功能的脑激活的研究可能会提高对运动功能恢复的潜在机制的理解，包括noninfarctedsemiles. Methods的作用8右利手恢复偏瘫或偏瘫患者，使用功能性MRI进行了研究。对每例患者的结果进行评价，以考虑原始功能组织、神经解剖学、梗死面积和范围、治疗、年龄和性别的个体差异。结果也被合并为一组与对照组的8个右撇子normal subjects.Results-In八个中风患者中的六个比较，延长激活同侧感觉运动皮层，它观察到在麻痹的手运动。在这些sis患者中，有3例记录了初级感觉运动皮层的双侧激活，其余3例仅记录了同侧激活。只有两名患者有轻度的联带运动。此外，在两名男性患者中，与正常受试者相比，麻痹性手部运动激活了同侧前运动区和背外侧前额叶皮层的扩展区域。在两名患者左额叶梗死，深刻的激活在右侧缘上回和轻运动前皮层观察到同侧麻痹的手movements. Conclusions-联动单独不能解释同侧激活的程度在初级感觉运动皮层。我们的研究结果提供的解释是，预先存在的未交叉的运动神经通路可能被访问或招募，以弥补缺血性中风后交叉运动通路的损害。
Background aim Purpose-Studies of cerebral activation of motor function after ischemic stroke may enhance understanding of the underlying mechanisms of motor functional recovery, including the role of the noninfarcted hemisphere.Methods-Eight right-handed recovering hemiparetic or hemiplegic patience, were studied using functional MRI. Results were evaluated for each patient to consider individual variability in original functional organization, neuroanatomy, infarct size and extent, treatment, age, and sex. The results were also pooled as a group for comparison with a control group of eight right-handed normal subjects.Results-In six of eight stroke patients, extended activation in ipsilateral sensorimotor cortex it as observed during paretic hand movements. Bilateral activation of the primary sensorimotor cortex was recorded in three of these sis patients; ipsilateral activation alone was recorded in the remaining three patients. Only two patients had mild synkinesia. Furthermore, in two male patients, the paretic hand movements activated extended areas of ipsilateral premotor and dorsolateral prefrontal cortex, when compared with normal subjects. In two patients with left frontal infarction, profound activation in the right supramarginal gyrus and in the light premotor cortex was observed during the ipsilateral paretic hand movements.Conclusions-Synkinesia alone cannot explain the extent of ipsilateral activation in primary sensorimotor cortex. The explanation offered for our findings is that preexisting uncrossed motor neural pathways may be accessed or recruited to compensate for damage to the crossed motor pathways after ischemic stroke.