THE FUNCTIONAL-ANATOMY OF MOTOR RECOVERY AFTER STROKE IN HUMANS - A STUDY WITH POSITRON EMISSION TOMOGRAPHY
THE FUNCTIONAL-ANATOMY OF MOTOR RECOVERY AFTER STROKE IN HUMANS - A STUDY WITH POSITRON EMISSION TOMOGRAPHY
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DOI：
10.1002/ana.410290112
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发表时间：
1991-01-01
影响因子：
11.2
通讯作者：
FRACKOWIAK, RSJ
中科院分区：
文献类型：
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作者：
CHOLLET, F;DIPIERO, V;FRACKOWIAK, RSJ
我们研究了6例首次偏瘫中风患者康复后局部脑血流的变化。所有患者都有一个明确的大脑半球病变和至少一个单侧臂瘫，后来都恢复了。每例患者分别在静息状态、患手手指活动时和正常手手指活动时分别进行6次正电子断层扫描和2次脑血流量测定。当正常手指活动时，对侧初级感觉运动皮质和同侧小脑半球的局部脑血流量显著增加。当手指活动时，对侧和同侧初级感觉运动皮质和双侧小脑半球的局部脑血流量均显著增加。其他区域，即岛、顶下和运动前皮质，也随着恢复的手的运动而双侧激活。我们还使用一种新的图像分析技术，展示了在这些运动过程中，丘脑核团与特定的皮质和小脑区域之间的不同功能联系。我们的结果提示，同侧运动通路可能在缺血性卒中后运动功能的恢复中发挥作用。
We have studied regional cerebral blood flow changes in 6 patients after their recovery from a first hemiplegic stroke. All had a single well-defined hemispheric lesion and at least a brachial monoparesis that subsequently recovered. Each patient had a 6 measurements of cerebral blood flow by positron tomography with 2 scans at rest, 2 during movement of fingers of the recovered hand, and 2 during movement of fingers of the normal hand. When the normal fingers were moved, regional cerebral blood flow increased significantly in contralateral primary sensorimotor cortex and in the ipsilateral cerebellar hemisphere. When the fingers of the recovered hand were moved, significant regional cerebral blood flow increases were observed in both contralateral and ipsilateral primary sensorimotor cortex and in both cerebellar hemispheres. Other regions, namely, insula, inferior parietal, and premotor cortex, were also bilaterally activated with movement of the recovered hand. We have also demonstrated, by using a new technique of image analysis, different functional connections between the thalamic nuclei and specific cortical and cerebellar regions during these movements. Our results suggest that ipsilateral motor pathways may play a role in the recovery of motor function after ischemic stroke.