Functional reorganization and stability of somatosensory-motor cortical topography in a tetraplegic subject with late recovery
Functional reorganization and stability of somatosensory-motor cortical topography in a tetraplegic subject with late recovery
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DOI：
10.1073/pnas.262669099
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发表时间：
2002-12-24
影响因子：
11.1
通讯作者：
McDonald, JW
中科院分区：
文献类型：
--
作者：
Corbetta, M;Burton, H;McDonald, JW
研究了一位高位颈髓损伤患者的躯体感觉和运动皮层的功能组织，该患者肩部及以下几乎所有感觉/运动功能缺失5年，在经过强烈和持续的康复治疗后，6-8年内很少恢复某些功能。我们使用功能性磁共振成像来研究大脑对振动刺激的活动以及病变上下身体部位的自主运动。在初级躯体感觉皮质（SI）手部区域中没有观察到对手部振动刺激的反应，相反，在舌头运动期间，该区域会被招募，而舌头运动通常只在更外侧的面部区域引起反应。这一结果表明SI重组类似于以前报道的动物和人类外周病变后的神经可塑性变化。在鲜明的对比，振动刺激的脚诱发地形适当的反应，在SI和第二体感皮层（SII）。运动皮层的反应，与视觉跟踪任务，显示了一个近典型的地形，虽然他们更广泛的运动前区。这些发现表明，脊髓损伤后几年内，在没有明显运动或意识感觉的情况下，可能保留运动和一些躯体感觉皮层代表，并对未来的康复和神经修复治疗产生影响。
The functional organization of somatosensory and motor cortex was investigated in an individual with a high cervical spinal cord injury, a 5-year absence of nearly all sensory/motor function at and below the shoulders, and rare recovery of some function in years 6-8 after intense and sustained rehabilitation therapies. We used functional magnetic resonance imaging to study brain activity to vibratory stimulation and voluntary movements of body parts above and below the lesion. No response to vibratory stimulation of the hand was observed in the primary somatosensory cortex (SI) hand area, which was conversely recruited during tongue movements that normally evoke responses only in the more lateral face area. This result suggests SI reorganization analogous to previously reported neuroplasticity changes after peripheral lesions in animals and humans. In striking contradistinction, vibratory stimulation of the foot evoked topographically appropriate responses in SI and second somatosensory cortex (SII). Motor cortex responses, tied to a visuomotor tracking task, displayed a near typical topography, although they were more widespread in premotor regions. These findings suggest possible preservation of motor and some somatosensory cortical representations in the absence of overt movements or conscious sensations for several years after spinal cord injury and have implications for future rehabilitation and neural-repair therapies.