Brain Changes Associated with Postural Training in Patients with Cerebellar Degeneration: A Voxel-Based Morphometry Study
Brain Changes Associated with Postural Training in Patients with Cerebellar Degeneration: A Voxel-Based Morphometry Study
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DOI：
10.1523/jneurosci.3381-12.2013
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发表时间：
2013-03-06
影响因子：
5.3
通讯作者：
Timmann, Dagmar
中科院分区：
文献类型：
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作者：
Burciu, Roxana Gabriela;Fritsche, Nicole;Timmann, Dagmar
最近的研究表明，物理治疗可以改善小脑变性患者的运动表现。鉴于小脑对运动学习的已知贡献，目前尚不清楚这种可观察到的表现变化是否由小脑或参与运动控制和学习的大脑区域介导。目前的研究通过使用基于体素的形态测量评估小脑患者感觉运动训练引起的灰质体积增加来解决这个问题。19名患有单纯小脑变性的人类受试者和匹配的健康对照者在平衡任务上训练2周。在训练前和训练后进行姿势和临床评估沿着结构磁共振成像。主要调查结果如下。首先，训练增强了小脑患者的平衡能力。第二，与对照组相比，患者的背侧运动前区皮质的训练后灰质体积显着增加。第三，在小脑内观察到与训练相关的灰质体积增加，并且在对照组中比患者更明显。然而，统计学上小脑的变化处于趋势水平，因此需要额外的独立确认。我们的结论是，小脑神经变性患者的感觉运动训练主要在小脑皮质环的未受影响的新皮质区域内诱导灰质变化。小脑的剩余功能似乎被利用，这表明在剩余的健康组织中，小脑可塑性的退化或完整过程的恢复。
Recent research indicates that physiotherapy can improve motor performance of patients with cerebellar degeneration. Given the known contributions of the cerebellum to motor learning, it remains unclear whether such observable changes in performance are mediated by the cerebellum or cerebral brain areas involved in motor control and learning. The current study addressed this question by assessing the increase in gray matter volume due to sensorimotor training in cerebellar patients using voxel-based morphometry. Nineteen human subjects with pure cerebellar degeneration and matched healthy controls were trained for 2 weeks on a balance task. Postural and clinical assessments along with structural magnetic resonance imaging were performed pretraining and post-training. The main findings were as follows. First, training enhanced balance performance in cerebellar patients. Second, in contrast to controls patients revealed significantly more post-training gray matter volume in the dorsal premotor cortex. Third, training-related increase in gray matter volume was observed within the cerebellum and was more pronounced in controls than in patients. However, statistically cerebellar changes were at the trend level and thus require additional, independent confirmation. We conclude that sensorimotor training of patients with cerebellar neurodegeneration induces gray matter changes primarily within nonaffected neocortical regions of the cerebellar-cortical loop. Residual function of the cerebellum appears to be exploited suggesting either a recovery from degeneration or intact processes of cerebellar plasticity in the remaining healthy tissue.