Shimizu T, Nariai T, Maehara T, Hino T, Komori T, Shimizu H, Hirai S, Senda M
Department of Neurology, Tokyo Metropolitan Neurological Hospital, Fuchu, Japan.
Neuroreport. 2000 Sep 28;11(14):3077-84. doi: 10.1097/00001756-200009280-00009.
We evaluated motor cortical excitability of the unaffected hemisphere in three patients with intractable epilepsy who underwent hemispherectomy, using transcranial magnetic stimulation (TMS) and PET. TMS of the unaffected hemisphere evoked motor responses not only in the contralateral muscles but also in the ipsilateral ones in all the patients. A PET study in one patient showed activation of the unaffected motor cortex by movement of either arm. All of these responses were enhanced after the hemispherectomy, probably due to motor cortical disinhibition by transection of the corpus callosum. The PET study also showed postoperative activation of the premotor area of the unaffected hemisphere. These phenomena indicate posthemispherectomy neuroplastic reorganization leading to preservation of the motor function after the operation.
我们使用经颅磁刺激（TMS）和正电子发射断层扫描（PET），对3例接受大脑半球切除术的难治性癫痫患者未受影响半球的运动皮质兴奋性进行了评估。在所有患者中，对未受影响半球进行TMS不仅在对侧肌肉而且在同侧肌肉中诱发了运动反应。对1例患者进行的PET研究显示，任一手臂运动均激活了未受影响的运动皮质。半球切除术后，所有这些反应均增强，这可能是由于胼胝体横断导致运动皮质去抑制所致。PET研究还显示，未受影响半球的运动前区术后被激活。这些现象表明，大脑半球切除术后的神经可塑性重组导致术后运动功能得以保留。
