Improvement and Neuroplasticity after Combined Rehabilitation to Forced Grasping.
Improvement and Neuroplasticity after Combined Rehabilitation to Forced Grasping.
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DOI：
10.1155/2017/1028390
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发表时间：
2017
影响因子：
0.9
通讯作者：
Shimodozono M
中科院分区：
文献类型：
--
作者：
Arima M;Ogata A;Kawahira K;Shimodozono M
抓握反射是一种令人痛苦的症状，但在文献中很少讨论治疗或抑制它的必要性。我们报告的情况下，17岁的男子谁曾遭受脑梗死的右侧壳核和颞叶10年前。偏瘫左上肢的强制抓握在独特的综合治疗后得到改善。A型肉毒毒素（BTX-A）首先注射到左二头肌、腕屈肌和手指屈肌。随着上肢痉挛，强制抓握减少。此外，在低振幅连续神经肌肉电刺激下进行重复性促进性运动和物体相关训练。由于这2周的治疗改善了上肢功能，我们比较了联合治疗前后的大脑活动，用近红外光谱测量了捏手指期间的活动。治疗后电刺激下同侧感觉运动皮层（SMC）和内侧额叶皮层（MFC）的脑活动明显高于治疗前。结果表明，BTX-A治疗后的电刺激训练可能调节同侧SMC和MFC的活动，并导致患肢强制抓取功能的改善。
The grasp reflex is a distressing symptom but the need to treat or suppress it has rarely been discussed in the literature. We report the case of a 17-year-old man who had suffered cerebral infarction of the right putamen and temporal lobe 10 years previously. Forced grasping of the hemiparetic left upper limb was improved after a unique combined treatment. Botulinum toxin type A (BTX-A) was first injected into the left biceps, wrist flexor muscles, and finger flexor muscles. Forced grasping was reduced along with spasticity of the upper limb. In addition, repetitive facilitative exercise and object-related training were performed under low-amplitude continuous neuromuscular electrical stimulation. Since this 2-week treatment improved upper limb function, we compared brain activities, as measured by near-infrared spectroscopy during finger pinching, before and after the combined treatment. Brain activities in the ipsilesional sensorimotor cortex (SMC) and medial frontal cortex (MFC) during pinching under electrical stimulation after treatment were greater than those before. The results suggest that training under electrical stimulation after BTX-A treatment may modulate the activities of the ipsilesional SMC and MFC and lead to functional improvement of the affected upper limb with forced grasping.