Motor impairment factors related to brain injury timing in early hemiparesis. Part I: expression of upper-extremity weakness.
Motor impairment factors related to brain injury timing in early hemiparesis. Part I: expression of upper-extremity weakness.
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DOI：
10.1177/1545968313500564
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发表时间：
2014-01
影响因子：
4.2
通讯作者：
Dewald JP
中科院分区：
文献类型：
--
作者：
Sukal-Moulton T;Krosschell KJ;Gaebler-Spira DJ;Dewald JP
广泛的神经运动发育发生在人类生命的早期，但在量化运动损伤时，尚未对发育过程中脑损伤发生的时间进行严格研究。这项研究调查了脑损伤时间对儿童期偏瘫患者瘫痪手臂无力程度和分布的影响。将 24 名偏瘫患者分为出生前（产前，n=8）、出生前后（围产期，n=8）或 6 个月后（产后，n=8）受伤的时间段。他们与 8 名典型发展同伴一起参与了最大等距肩部、肘部、手腕和手指扭矩生成任务，使用多自由度称重传感器量化 10 个方向的扭矩。使用混合模型方差分析来确定组和任务对计算出的臂间相对弱点比的影响。损伤时间组（p<0.001）和关节扭矩方向（p<0.001）对瘫痪手臂的相对无力都有显着影响。与近端关节相比，远端关节受到的影响更大，尤其是在产后组。无力的分布为较早受伤的个体中通往麻痹肢体的同侧皮质脊髓运动通路的相对保留提供了证据，而那些较晚受伤的个体在用麻痹手臂产生扭矩期间可能更多地依赖于间接的同侧皮质-球脊髓投射。
Extensive neuromotor development occurs early in human life, but the time that a brain injury occurs during development has not been rigorously studied when quantifying motor impairments. This study investigated the impact of timing of brain injury on magnitude and distribution of weakness in the paretic arm of individuals with childhood-onset hemiparesis. Twenty-four individuals with hemiparesis were divided into time periods of injury before birth (PRE-natal, n=8), around the time of birth (PERI-natal, n=8) or after 6 months of age (POST-natal, n=8). They, along with 8 typically developing peers, participated in maximal isometric shoulder, elbow, wrist, and finger torque generation tasks using a multiple degree-of-freedom load cell to quantify torques in 10 directions. A mixed model ANOVA was used to determine the effect of group and task on a calculated relative weakness ratio between arms. There was a significant effect of both time of injury group (p<0.001) and joint torque direction (p<0.001) on the relative weakness of the paretic arm. Distal joints were more affected compared to proximal joints, especially in the POST-natal group. The distribution of weakness provides evidence for the relative preservation of ipsilateral corticospinal motor pathways to the paretic limb in those individuals injured earlier, while those who sustained later injury may rely more on indirect ipsilateral cortico-bulbospinal projections during the generation of torques with the paretic arm.
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影响因子：
3.7
作者：
GALEA, MP;DARIANSMITH, I
通讯作者：
DARIANSMITH, I
影响因子：
3.8
作者：
Carr, LJ
通讯作者：
Carr, LJ
影响因子：
4.3
作者：
Damiano, DL;Martellotta, TL;Abel, MF
通讯作者：
Abel, MF
影响因子：
3.1
作者：
Feys, Hilde;Eyssen, Maria;De Cock, Paul
通讯作者：
De Cock, Paul
影响因子：
8.2
作者：
Eyre, J. A.
通讯作者：
Eyre, J. A.