Viswanathan Vijay, Chmayssani Mohamad, Adams David J, Hirsch Joy
Department of Radiology, Harlem Hospital, and Department of Neurology, Columbia University Medical Center, Columbia University, New York, New York 10032, USA.
Neuroreport. 2006 Nov 6;17(16):1669-73. doi: 10.1097/01.wnr.0000239953.60695.08.
We distinguish between two models of adult cortical reorganization, adaptive and constant somatotopy, using functional magnetic resonance imaging maps corresponding to individual thumb and fourth-finger digits in a patient with a right-hand fourth digit tendon transfer that salvaged impaired function of the right thumb. Comparison of motor and sensory maps for both digits and both hands was consistent with a model of 'adaptive somatotopy' in which thumb control was taken over by regions adjacent to the fourth finger control cluster rather than at the presurgical lateral region as predicted by a model of 'constant somatotopy'. These findings are the first to demonstrate that rerouting of peripheral input, in the absence of brain injury, is sufficient to drive cortical reorganization resulting in recovery of lost motor function, and further suggest an adaptive mechanism associated with brain tissue engaged in intact motor functions.
我们利用功能磁共振成像图区分了成人皮质重组的两种模式，即适应性和恒定躯体感觉定位，该成像图对应于一名右手无名指肌腱转移患者的个体拇指和第四指，该手术挽救了右手拇指受损的功能。对双手两个手指的运动和感觉图谱进行比较，结果与“适应性躯体感觉定位”模型一致，在该模型中，拇指控制由与第四指控制簇相邻的区域接管，而不是如“恒定躯体感觉定位”模型所预测的术前外侧区域。这些发现首次证明，在没有脑损伤的情况下，外周输入的重新布线足以驱动皮质重组，从而恢复丧失的运动功能，并进一步表明存在一种与参与完整运动功能的脑组织相关的适应性机制。
