Predominant involvement of a particular group of fingers due to small, cortical infarction
Predominant involvement of a particular group of fingers due to small, cortical infarction
复制标题
DOI：
10.1212/wnl.56.12.1677
复制
发表时间：
2001-06-26
期刊：
影响因子：
9.9
通讯作者：
Kim, JS
中科院分区：
文献类型：
--
作者：
Kim, JS
背景：小的皮质卒中可能导致局限于特定手指组的明显无力。然而，临床，放射学和病因学研究很少在这些患者中进行。方法：作者分析了12例以特定手指无力为主要表现的小皮质梗塞的临床和影像学特点。结果如下：患者分为两组：8例患者主要累及尺侧手指（PIUF），4例主要累及桡侧手指（PIRF）。感觉症状也存在于8例患者中，其严重程度与运动障碍相关。放射学-临床相关性显示，在运动皮质的假定手代表区中，与PIUF相关的病变比与PIRF相关的病变明显位于内侧。此外，PIUF与严重的近端血管狭窄或闭塞密切相关，而PIRF通常与栓塞性卒中相关。结论：结果同意传统上声称的地形为手指在人类运动皮层：尺手指内侧和桡手指外侧。然而，这一结果是否表明个体神经元兴奋性的点到点躯体位置表示或差异阈值仍然未知。感觉地形图似乎与个体受试者的运动功能密切相关。代表尺侧手指的运动皮层可能是大动脉之间的边界区。
Background: Small cortical strokes may cause predominant weakness restricted to a particular group of fingers. However, clinical, radiologic, and etiopathogenetical studies have rarely been done in these patients. Method: The author analyzed clinical and radiologic features of 12 patients with small cortical infarcts who had predominant weakness of particular fingers. Results: The patients were divided into two groups: Eight patients had predominant involvement of ulnar-sided fingers (PIUF), and four had predominant involvement of radial-sided fingers (PIRF). Sensory symptoms were also present in eight patients, and the severity correlated with that of motor impairment. Radiologic-clinical correlation showed that the lesions related to PIUF were located significantly more medially than those associated with PIRF in the presumed hand representation area of the motor cortex. In addition, the PIUF was closely associated with severe proximal vessel stenosis or occlusion, whereas the PIRF was often related to emboligenic stroke. Conclusions: The results agree with traditionally alleged topography for fingers in the human motor cortex: ulnar fingers-medial and radial fingers-lateral. However, whether this result indicates a point-to-point somatotopical representation or differential threshold of excitability in individual neurons remains unknown. Sensory topography seems to be closely associated with that of motor function in individual subjects. The motor cortex representing ulnar-sided fingers may be a borderzone area between large arteries.