Wittenberg G F, Bastian A J, Dromerick A W, Thach W T, Powers W J
Department of Neurology and Neurological Surgery, Washington University School of Medicine, Saint Louis, Missouri, USA.
Neurorehabil Neural Repair. 2000;14(3):213-21. doi: 10.1177/154596830001400307.
In recovered stroke patients, performance of motor tasks with the affected limb has been reported to activate cortical areas ipsilateral to the affected side. The better to determine the causal role these areas play in recovery of motor function, we assessed cerebral activation during motor activity longitudinally after hemiparesis due to cerebral infarction. A secondary goal was to ascertain the relation between mirror movements and activation ipsilateral to motor activity. Positron emission tomography with oxygen-15 water measured regional cerebral blood flow during wrist movement early and late in the course of recovery from hemiparesis. Surface electromyography recorded muscular activity, and computer-assisted video analysis quantified movement during the scans. Mirror movements, movements contralateral to the instructed movement of the hemiparetic arm, were often seen. Activation of motor areas in the hemisphere ipsilateral to the affected limb roughly correlated with presence of mirror movements. Other changes in cerebral activation were small, when the task was controlled for rate, but high-rate-specific recruitment of ipsilateral cortical areas occurred in one case. However, the common occurrence of mirror movements, particularly with effortful tasks, complicates interpretation of data regarding the role of the ipsilateral hemisphere in recovery.
据报道，在中风康复患者中，使用患侧肢体执行运动任务会激活患侧同侧的皮质区域。为了更好地确定这些区域在运动功能恢复中所起的因果作用，我们在脑梗死导致偏瘫后，纵向评估了运动活动期间的脑激活情况。第二个目标是确定镜像运动与运动活动同侧激活之间的关系。使用氧-15水进行正电子发射断层扫描，测量偏瘫恢复过程早期和晚期手腕运动期间的局部脑血流量。表面肌电图记录肌肉活动，计算机辅助视频分析在扫描期间对运动进行量化。经常会出现镜像运动，即与偏瘫手臂指令运动对侧的运动。患侧肢体同侧半球运动区域的激活大致与镜像运动的存在相关。当任务以速度进行控制时，脑激活的其他变化很小，但在一个病例中出现了同侧皮质区域的高速率特异性募集。然而，镜像运动的普遍存在，尤其是在费力任务中，使得关于同侧半球在恢复中作用的数据解释变得复杂。
