Sensorimotor cortical changes assessed with resting-state fMRI following total brachial plexus root avulsion
Sensorimotor cortical changes assessed with resting-state fMRI following total brachial plexus root avulsion
复制标题
DOI：
10.1136/jnnp-2013-304956
复制
发表时间：
2014-01-01
影响因子：
11
通讯作者：
Gu, Yu-dong
中科院分区：
文献类型：
--
作者：
Qiu, Tian-ming;Chen, Liang;Gu, Yu-dong
目的周围神经损伤可引起即刻和长期的脑皮质重塑，影响神经修复的效果。方法对13例臂丛神经根性撕脱伤患者进行静息态fMRI检查，其中3例于术后7 ~ 8个月复查。检查时间为伤后1 ~ 16个月。9名健康成人作为对照。结果9例臂丛神经损伤后1 ~ 4个月首次进行功能磁共振成像的患者，伤侧对侧半球的手和手臂感觉运动区与辅助运动区（SMA）的相关性明显弱于伤侧同侧半球。另外4例患者在伤后7 ~ 16个月进行功能磁共振成像检查，观察到与手和手臂相对应的双侧皮层感觉运动区的对称图。对于9例不对称的皮质代表，第二次扫描表明对称的结果，甚至更强的相关性与SMA在大脑皮层对侧的受伤sides.Conclusions全臂丛根性撕脱导致臂丛神经的皮质代表进行一个变化，从一个不活跃的状态到一个活跃的状态。这意味着臂丛神经损伤后的外周传入阻滞将导致相应的皮质代表被相邻的非传入皮质区域占据。
Objective Peripheral nerve injury can induce immediate and long-standing remodelling of the brain cortex, which may affect outcomes of nerve repair. This study examined changes of corresponding cortical representations in patients with brachial plexus injuries.Methods Resting-state fMRI was acquired for 13 adult patients with total brachial plexus root avulsion, three of whom underwent second scans 7 or 8 months later. The time of examination ranged from 1 to 16 months after injuries. Nine healthy adults were enrolled as control. Seed-based functional connectivity was performed for all subjects.Results For nine patients whose first fMRI was performed from 1 to 4 months after brachial plexus injuries, images showed that their cortical maps of sensorimotor areas corresponding to the hand and arm in the hemisphere contralateral to the injured side had much weaker correlation with the supplementary motor area (SMA) than those ipsilateral to the injured side. Symmetrical maps of bilateral cortical sensorimotor areas corresponding to the hand and arm were observed in other four cases with fMRI tested from 7 to 16 months after injuries. For three of the nine patients with asymmetrical cortical representations, second scans indicated symmetric results or even stronger correlation with SMA in the cerebral cortex contralateral to the injured side.Conclusions Total brachial plexus root avulsion causes cortical representations of the brachial plexus to undergo a change from an inactive to an active state. This implies that peripheral deafferentation after brachial plexus injuries will induce corresponding cortical representations to be occupied by adjacent non-deafferented cortical territories.