Di Piero V, Chollet F M, MacCarthy P, Lenzi G L, Frackowiak R S
MRC Cyclotron Unit, Hammersmith Hospital, London, UK.
J Neurol Neurosurg Psychiatry. 1992 Nov;55(11):990-6. doi: 10.1136/jnnp.55.11.990.
The metabolic changes occurring after ischaemic stroke were measured to investigate the functional anatomy of clinical motor recovery. Positron emission tomography (PET) and the steady-state 15O technique was used to compare resting relative metabolic distributions at the onset of functional deficit with those following recovery. Ten patients were studied with repeat scans. Motor recovery was associated in some patients with an increase of relative oxygen metabolism in anatomical structures normally involved in motor function in the affected hemisphere, particularly in the cortical motor areas. In those patients without such metabolic changes in the cortex of the diseased hemisphere, relative increases in cortical metabolism in the contralateral hemisphere were associated with better motor recovery than in patients with no relative cortical metabolic increase in either hemisphere. There was no correlation between the degree of improvement in motor function and the severity of motor deficit at onset, the size and site of the lesion and the metabolic changes in the infarcted zone. No particular pattern of global metabolic changes was observed after recovery. Thus different relative patterns of metabolic recovery were seen in patients with different lesions and evidence was found for the participation of contralateral structures in the recovery process in some patients.
测量缺血性中风后发生的代谢变化，以研究临床运动恢复的功能解剖学。使用正电子发射断层扫描（PET）和稳态15O技术，比较功能缺损发作时的静息相对代谢分布与恢复后的情况。对10名患者进行了重复扫描研究。在一些患者中，运动恢复与患侧半球通常参与运动功能的解剖结构中相对氧代谢的增加有关，特别是在皮质运动区。在患侧半球皮质没有这种代谢变化的患者中，与两侧半球均无相对皮质代谢增加的患者相比，对侧半球皮质代谢的相对增加与更好的运动恢复相关。运动功能改善程度与发作时运动缺损的严重程度、病变的大小和部位以及梗死区的代谢变化之间没有相关性。恢复后未观察到特定的整体代谢变化模式。因此，在不同病变的患者中观察到不同的相对代谢恢复模式，并且发现有证据表明在某些患者的恢复过程中对侧结构参与其中。
