Compensatory Changes at the Cerebral Cortical Level after Spinal Cord Injury
Compensatory Changes at the Cerebral Cortical Level after Spinal Cord Injury
复制标题
DOI：
10.1177/1073858408331375
复制
发表时间：
2009-10-01
期刊：
影响因子：
5.6
通讯作者：
Isa, Tadashi
中科院分区：
文献类型：
--
作者：
Nishimura, Yukio;Isa, Tadashi
神经康复是基于这样一个概念，即康复训练招募在脑和/或脊髓损伤后保持完整的神经系统来接管受损的功能。了解康复的神经机制必将有助于循证康复疗法的发展。最近的研究表明，在颈中段外侧皮质脊髓束损伤后，猕猴的手指灵巧性在几周到几个月的时间内就能得到补偿。综合脑成像和运动皮质区域可逆的药物失活提示，恢复早期涉及双侧初级运动皮质，后期涉及对侧初级运动皮质和双侧运动前皮质的更广泛区域。因此，每个皮质区域的贡献取决于恢复阶段，这表明大脑在早期通过减少抑制来利用现有的神经系统，在后期通过神经回路的可塑性变化来增强原始系统或招募其他系统。这些运动相关区域激活模式的变化代表了脊髓损伤后功能代偿的适应性策略。
Neurorehabilitation is based oil the concept that rehabilitative training recruits neuronal systems that remain intact after the brain and/or spinal cord injury to take over the impaired function. Understanding, the neural mechanism of recovery will surely contribute to the development of evidence-based rehabilitation therapies. Recent studies have shown that after a lesion of the lateral corticospinal tract at midcervical segments, the remaining pathways can compensate for finger dexterity in macaque monkeys in a few weeks to months. Combined brain imaging and reversible pharmacological inactivation of motor cortical regions suggested that the recovery involves the bilateral primary motor cortex during the early recovery stage and more extensive regions of the contralesional primary motor cortex and bilateral premotor cortex during the late stage. Thus, contribution of each cortical region changes depending on the recovery stage, suggesting that the brain uses available pre-existing neural systems by reducing inhibition during the early stage and enhances the original systems or recruits other systems by plastic change of the neural circuits during the late stage. These changes in the activation pattern of motor-related areas represent an adaptive strategy for functional compensation after spinal cord injury.