Recruitment of additional brain regions to accomplish simple motor tasks in chronic alcohol-dependent patients.
Recruitment of additional brain regions to accomplish simple motor tasks in chronic alcohol-dependent patients.
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DOI：
10.1111/j.1530-0277.2010.01186.x
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发表时间：
2010-06
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影响因子：
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通讯作者：
M. H. Parks;D. S. Greenberg;Mark K Nickel;M. Dietrich;B. Rogers;Peter R. Martin
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作者：
M. H. Parks;D. S. Greenberg;Mark K Nickel;M. Dietrich;B. Rogers;Peter R. Martin
慢性酒精依赖患者（ALC）表现出归因于酒精诱导的额-小脑损伤的神经认知障碍。缺陷通常出现在复杂的任务表现，而简单的任务可能不会受到显着影响，也许是因为很少了解补偿性变化。方法：我们使用功能性磁共振成像（fMRI）比较了10对右手优势、年龄和性别匹配、严重、无并发症的ALC和正常对照组（NC）的手指在外部起搏（EP）或最大自主起搏（SP）频率下敲击以及伴随的大脑激活。结果：ALC和NC两种任务的平均叩击率无显著差异，但ALC双手的SP叩击差异较大。两组的优势手（DH）比非优势手（NDH）的SP敲击更快。EP和SP轻敲与非优势的手表现出显着更多的激活ALC比NC在中央前回和后回，额下回，顶下小叶，颞中回。在NDH敲击期间仅由ALC激活的区域（完全不由NC激活）包括额下回、颞中回和中央后回。DH攻牙组的激活差异不显著。NC的脑区激活没有ALC多。与EP相比，SP敲击激活NC的额-小脑网络，包括中央后回、前扣带回、小脑前叶和小脑蚓部，但仅激活ALC的顶叶楔前叶。结论：NDH手指敲击的这些发现支持了以前关于ALC神经认知功能低下的报道。下额叶激活与EP在ALC中，但不是在NC中，表明参与的区域需要规划，组织和冲动调节;更大的对侧顶叶激活与SP在ALC中可能反映右半球的视觉空间性能的损害。对比SP和EP过程中的大脑激活表明，ALC可能没有招募一个额小脑网络NC，而是采用了更高阶的规划模式，招募顶叶功能，以达到正常的平均手指敲击率。阐明的代偿性神经机制，允许近正常性能的ALC在简单的任务，可以告知功能康复的患者在恢复。
BACKGROUND Chronic alcohol-dependent patients (ALC) exhibit neurocognitive impairments attributed to alcohol-induced fronto-cerebellar damage. Deficits are typically found in complex task performance, whereas simple tasks may not be significantly compromised, perhaps because of little understood compensatory changes. METHODS We compared finger tapping with either hand at externally paced (EP) or maximal self-paced (SP) rates and concomitant brain activation in ten pairs of right-hand dominant, age-, and gender-matched, severe, uncomplicated ALC and normal controls (NC) using functional magnetic resonance imaging (fMRI). RESULTS Mean tapping rates were not significantly different in ALC and NC for either task, but SP tapping variances were greater in ALC for both hands. SP tapping was more rapid with dominant hand (DH) than non-dominant hand (NDH) for both groups. EP and SP tapping with the non-dominant hand demonstrated significantly more activation in ALC than NC in the pre and postcentral gyri, inferior frontal gyrus, inferior parietal lobule, and the middle temporal gyrus. Areas activated only by ALC (not at all by NC) during NDH tapping included the inferior frontal gyrus, middle temporal gyrus, and postcentral gyrus. There were no significant group activation differences with DH tapping. No brain regions activated more in NC than ALC. SP tapping in contrast to EP activated fronto-cerebellar networks in NC, including postcentral gyrus, anterior cingulate, and the anterior lobe and vermis of the cerebellum, but only parietal precuneus in ALC. CONCLUSIONS These findings with NDH finger tapping support previous reports of neurocognitive inefficiencies in ALC. Inferior frontal activation with EP in ALC, but not in NC, suggests engagement of regions needed for planning, organization, and impulse regulation; greater contralateral parietal lobe activation with SP in ALC may reflect right hemispheric impairments in visuospatial performance. Contrasting brain activation during SP and EP suggests that ALC may not have enlisted a fronto-cerebellar network as did NC but rather employed a higher order planning mode by recruiting parietal lobe functions to attain normal mean finger tapping rates. Elucidation of the compensatory neural mechanisms that allow near normal performance by ALC on simple tasks can inform functional rehabilitation of patients in recovery.