Thobois S, Dominey P F, Decety J, Pollak P P, Gregoire M C, Le Bars P D, Broussolle E
Department of Neurology and CERMEP, Neurological Hospital Pierre Wertheimer, Lyon, France.
Neurology. 2000 Oct 10;55(7):996-1002. doi: 10.1212/wnl.55.7.996.
To investigate, using PET and H2(15)O, brain activation abnormalities of patients with PD during motor imagery. To determine whether motor imagery activation patterns depend on the hand used to complete the task.
Previous work in PD has shown that bradykinesia is associated with slowness of motor imagery.
The PET study was performed in eight patients with PD with predominantly right-sided akinesia, and in eight age-matched control subjects, all right-handed. Regional cerebral blood flow was measured by PET and H2(15)O while subjects imagined a predetermined unimanual externally cued sequential movement with a joystick with either the left or the right hand, and during a rest condition.
In normal subjects, the prefrontal cortex, supplementary motor area (SMA), superior parietal lobe, inferior frontal gyrus, and cerebellum were activated during motor imagery with either the left or the right hand. Contralateral primary motor cortex activation was noted only when the task was imagined with the right (dominant) hand, whereas activation of the dorsolateral prefrontal cortex was observed only during imagery with the left hand. In patients with PD, motor imagery with the right ("akinetic") hand was characterized by lack of activation of the contralateral primary sensorimotor cortex and the cerebellum, persistent activation of the SMA, and bilateral activation of the superior parietal cortex. Motor imagery with the left ("non-akinetic") hand was also abnormal, with lack of activation of the SMA compared with controls.
In patients with PD with predominantly right-sided akinesia, brain activation during motor imagery is abnormal and may appear even with the less affected hand. In normal subjects, brain activation during motor imagery depends on the hand used in the imagined movement.
使用正电子发射断层扫描（PET）和H₂¹⁵O，研究帕金森病（PD）患者在运动想象过程中的脑激活异常情况。确定运动想象激活模式是否取决于完成任务所使用的手。
先前关于PD的研究表明，运动迟缓与运动想象的缓慢有关。
对8例以右侧运动不能为主的PD患者和8例年龄匹配的对照受试者（均为右利手）进行PET研究。在受试者用左手或右手想象使用操纵杆进行预定的单手动外部提示顺序运动时，以及在静息状态下，通过PET和H₂¹⁵O测量局部脑血流量。
在正常受试者中，无论用左手还是右手进行运动想象时，前额叶皮质、辅助运动区（SMA）、顶上叶、额下回和小脑均被激活。仅当用右手（优势手）想象任务时，对侧初级运动皮质才被激活，而仅在左手想象时观察到背外侧前额叶皮质的激活。在PD患者中，用右手（“运动不能的”）进行运动想象的特征是对侧初级感觉运动皮质和小脑未被激活，SMA持续激活，以及顶上叶皮质双侧激活。用左手（“非运动不能的”）进行运动想象也不正常，与对照组相比，SMA未被激活。
在以右侧运动不能为主的PD患者中，运动想象期间的脑激活是异常的，即使使用受影响较小的手也可能出现这种情况。在正常受试者中，运动想象期间的脑激活取决于想象运动中使用的手。
