Critical reorganization in patients with facial palsy
Critical reorganization in patients with facial palsy
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DOI：
10.1002/ana.410410511
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发表时间：
1997-05-01
影响因子：
11.2
通讯作者：
Weiller, C
中科院分区：
文献类型：
--
作者：
Rijntjes, M;Tegenthoff, M;Weiller, C
通过经颅磁刺激（TMS）和正电子发射断层扫描（PET）研究面瘫患者皮层组织可能发生的变化，作为外周运动脱神经的模型。采用经颅磁刺激法比较8例患者拇短外展肌产生肌肉诱发电位（MEP）区域的大小、该区域内MEP振幅之和以及两脑映射区域上的体积。使用PET，比较6例患者和6名健康志愿者在顺序手指对立时，用标准(H2O2)-O-15注射技术测量的区域脑血流量的增加。面瘫患者移动同侧手，对照组移动右手。9例患者中有5例同时参加了两项实验。两种方法均发现面瘫对侧手野扩大，沿外侧方向延伸至假定的面部区域。PET数据显示，手区在体感皮层（SMC）的扩大是广泛的皮层重组的一部分，包括同侧SMC和双侧次级运动和感觉区。我们首次报道，使用两种不同的非侵入性方法，外周，仅仅运动去分化是一个足够的刺激重组变化在健康的成人皮层。
Possible changes in the organization of the cortex in patients with facial palsy, serving as a model of peripheral motor deefferentation, were investigated by using transcranial magnetic stimulation (TMS) and positron emission tomography (PET). With TMS, the size of the area producing muscle-evoked potentials (MEPs) of the abductor pollicis brevis muscle, the sum of MEP amplitudes within this area, and the volume over the mapping area were compared between both hemispheres in 8 patients. With PET, increases in regional cerebral blood flow, measured with the standard (H2O2)-O-15 bolus injection technique, were compared between 6 patients and 6 healthy volunteers during sequential finger opposition. Patients moved the hand ipsilateral to the facial palsy, the control subjects the right hand. Of 9 patients in total, 5 participated in both experiments. With both methods, an enlargement of the hand field contralateral to the facial palsy was found, extending in a lateral direction, into the site of the presumed face area. The PET data showed that the enlargement of the hand field in the somatosensory cortex (SMC) is part of a widespread cortical reorganization, including the ipsilateral SMC and bilateral secondary motor and sensory areas. We report for the first time, using two different noninvasive methods, that peripheral, mere motor deefferentation is a sufficient stimulus for reorganizational changes in the healthy adult human cortex.