Motor system activation after subcortical stroke depends on corticospinal system integrity.
Motor system activation after subcortical stroke depends on corticospinal system integrity.
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DOI：
10.1093/brain/awl002
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发表时间：
2006-03
期刊：
影响因子：
--
通讯作者：
Frackowiak RS
中科院分区：
文献类型：
--
作者：
Ward NS;Newton JM;Swayne OB;Lee L;Thompson AJ;Greenwood RJ;Rothwell JC;Frackowiak RS
皮质下卒中后运动相关的脑激活模式的特点是与对照组相比，皮质运动区相对过度激活。在能够执行运动任务的患者中，过度激活在运动障碍较多的患者中更严重。我们假设，招聘的运动区域将转移从初级到二级运动网络的皮质脊髓系统（CSS）的功能完整性受损的反应。我们在8名慢性皮质下卒中患者的运动任务中使用功能性MRI测量了大脑激活的幅度。使用经颅磁刺激评估CSS功能完整性，以获得受影响的第一背侧骨间肌的刺激/反应曲线，梯度较浅，代表CSS功能完整性的破坏增加。结果表明，刺激反应曲线的斜率与脑内运动相关区的激活强度呈负相关，包括病灶侧的后初级运动皮层（Brodmann area，BA 4p）、病灶对侧的前初级运动皮层（BA 4a）、双侧运动前皮层、辅助运动区、顶内沟、背外侧前额叶皮层和病灶对侧的上级扣带回沟。在任何脑区都没有显著的正相关。这些结果表明，受损的功能完整性的CSS与招聘的二级运动网络在两个半球，试图产生运动输出脊髓运动神经元。次级运动区在产生运动输出方面效率较低，因此这种重组只能被认为在减少中风后运动障碍方面部分成功。
Movement-related brain activation patterns after subcortical stroke are characterized by relative overactivations in cortical motor areas compared with controls. In patients able to perform a motor task, overactivations are greater in those with more motor impairment. We hypothesized that recruitment of motor regions would shift from primary to secondary motor networks in response to impaired functional integrity of the corticospinal system (CSS). We measured the magnitude of brain activation using functional MRI during a motor task in eight chronic subcortical stroke patients. CSS functional integrity was assessed using transcranial magnetic stimulation to obtain stimulus/response curves for the affected first dorsal interosseus muscle, with a shallower gradient representing increasing disruption of CSS functional integrity. A negative correlation between the gradient of stimulus/response curve and magnitude of task-related brain activation was found in several motor-related regions, including ipsilesional posterior primary motor cortex [Brodmann area (BA) 4p], contralesional anterior primary motor cortex (BA 4a), bilateral premotor cortex, supplementary motor area, intraparietal sulcus, dorsolateral prefrontal cortex and contralesional superior cingulate sulcus. There were no significant positive correlations in any brain region. These results suggest that impaired functional integrity of the CSS is associated with recruitment of secondary motor networks in both hemispheres in an attempt to generate motor output to spinal cord motoneurons. Secondary motor regions are less efficient at generating motor output so this reorganization can only be considered partially successful in reducing motor impairment after stroke.
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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：
4.4
作者：
DOlhaberriague, L;Gamissans, JME;Seoane, JL
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Seoane, JL
影响因子：
14.5
作者：
HEALD, A;BATES, D;MILLER, S
通讯作者：
MILLER, S
影响因子：
5.7
作者：
Geyer, S;Schleicher, A;Zilles, K
通讯作者：
Zilles, K
影响因子：
4.7
作者：
Foltys, H;Krings, T;Töpper, R
通讯作者：
Töpper, R