Cerebral activation during motor imagery in complex regional pain syndrome type 1 with dystonia
Cerebral activation during motor imagery in complex regional pain syndrome type 1 with dystonia
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DOI：
10.1016/j.pain.2007.04.029
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发表时间：
2008-02-01
期刊：
影响因子：
7.4
通讯作者：
Leenders, Klaus L.
中科院分区：
文献类型：
--
作者：
Gieteling, Esther W.;van Rijn, Monique A.;Leenders, Klaus L.
复杂性局部疼痛综合征1型（CRPS-1）肌张力障碍的发病机制尚不清楚。在原发性肌张力障碍中，功能性磁共振成像（fMRI）揭示了运动执行过程中大脑网络的变化。本研究的目的是确定CRPS-1患者的张力障碍姿势的脑网络功能。脑处理相关的执行和想象的手运动的患者和对照组进行了评估与功能磁共振成像。8例CRPS-1患者右上肢肌张力障碍姿势和17名年龄匹配的健康对照进行了研究。与对照组相比，受影响的手在患者的想象运动表现出减少激活同侧的前运动区和相邻的前额叶皮层，并在一个集群，包括额盖，岛叶皮层的前部和上级颞回。在双侧，下顶叶和邻近的初级感觉皮层的激活减少。当他们执行动作时，患者和对照组之间没有差异，当他们想象移动他们未受影响的手时也没有差异。CRPS-I相关肌张力障碍患者的脑激活模式改变很可能反映了疼痛相关回路和高阶运动控制之间的界面，这指向了这种类型肌张力障碍的特定机制病理生理学。(c)2007年国际疼痛研究协会。Elsevier B. V.出版，保留所有权利。
The pathogenesis of dystonia in Complex Regional Pain Syndrome type 1 (CRPS-1) is unclear. In primary dystonia, functional magnetic resonance imaging (fMRI) has revealed changes in cerebral networks during execution of movement. The aim of this study was to determine cerebral network function in CRPS-1 patients with dystonic postures. Cerebral processing related to both execution and imagining of hand movements in patients and controls was assessed with fMRI. Eight CRPS-1 patients with dystonic postures of the right upper extremity and 17 age-matched healthy controls were studied. Compared with controls, imaginary movement of the affected hand in patients showed reduced activation ipsilaterally in the premotor and adjacent prefrontal cortex, and in a cluster comprising frontal operculum, the anterior part of the insular cortex and the superior temporal gyrus. Contralaterally, reduced activation was seen in the inferior parietal and adjacent primary sensory cortex. There were no differences between patients and controls when they executed movements, nor when they imagined moving their unaffected hand. The altered cerebral activation pattern in patients with CRPS-I linked dystonia most likely reflects an interface between pain-associated circuitry and higher order motor control, which points at a specific mechanistic pathophysiology of this type of dystonia. (c) 2007 International Association for the Study of Pain. Published by Elsevier B.V. All rights reserved.