Altamura Claudia, Torquati Kahtya, Zappasodi Filippo, Ferretti Antonio, Pizzella Vittorio, Tibuzzi Francesco, Vernieri Fabrizio, Pasqualetti Patrizio, Landi Doriana, Del Gratta Cosimo, Romani Gian-Luca, Maria Rossini Paolo, Tecchio Franca
Neurologia Clinica, Università Campus Biomedico, Rome, Italy.
Exp Neurol. 2007 Apr;204(2):631-9. doi: 10.1016/j.expneurol.2006.12.017. Epub 2006 Dec 29.
Growing evidence emphasizes a positive role of brain ipsilesional (IL) reorganization in stroke patients with partial recovery. Ten patients affected by a monohemispheric stroke in the middle cerebral artery territory underwent functional magnetic resonance (fMRI) and magnetoencephalography (MEG) evaluation of the primary sensory (S1) activation via the same paradigm (median nerve galvanic stimulation). Four patients did not present S1 fMRI activation [Rossini, P.M., Altamura, C., Ferretti, A., Vernieri, F., Zappasodi, F., Caulo, M., Pizzella, V., Del Gratta, C., Romani, G.L., Tecchio, F., 2004. Does cerebrovascular disease affect the coupling between neuronal activity and local haemodynamics? Brain 127, 99-110], although inclusion criteria required bilateral identifiable MEG responses. Mean Euclidean distance between fMRI and MEG S1 activation Talairach coordinates was 10.1+/-2.9 mm, with a 3D intra-class correlation (ICC) coefficient of 0.986. Interhemispheric asymmetries, evaluated by an MEG procedure independent of Talairach transformation, were outside or at the boundaries of reference ranges in 6 patients. In 3 of them, the IL activation presented medial or lateral shift with respect to the omega-shaped post-rolandic area while in the other 3, IL areas were outside the peri-rolandic region. In conclusion, despite dissociated intensity, the MEG and fMRI activations displayed good spatial consistency in stroke patients, thus confirming excessive interhemispheric asymmetries as a suitable indicator of unusual recruitments in the ipsilesional hemisphere, within or outside the peri-rolandic region.
越来越多的证据表明,大脑患侧(IL)重组在部分恢复的中风患者中发挥着积极作用。10例大脑中动脉区域单半球中风患者通过相同范式(正中神经电刺激)接受了初级感觉区(S1)激活的功能磁共振成像(fMRI)和脑磁图(MEG)评估。4例患者未出现S1 fMRI激活[Rossini, P.M., Altamura, C., Ferretti, A., Vernieri, F., Zappasodi, F., Caulo, M., Pizzella, V., Del Gratta, C., Romani, G.L., Tecchio, F., 2004. 脑血管疾病是否会影响神经元活动与局部血流动力学之间的耦合?《大脑》127卷,99 - 110页],尽管纳入标准要求双侧可识别的MEG反应。fMRI和MEG S1激活Talairach坐标之间的平均欧几里得距离为10.1±2.9毫米,三维组内相关(ICC)系数为0.986。通过独立于Talairach变换的MEG程序评估的半球间不对称性在6例患者中超出或处于参考范围的边界。其中3例患者中,患侧激活相对于ω形罗兰后区呈现内侧或外侧移位,而在另外3例中,患侧区域位于罗兰周围区域之外。总之,尽管强度分离,但MEG和fMRI激活在中风患者中显示出良好的空间一致性,从而证实半球间过度不对称是罗兰周围区域内外患侧半球异常募集的合适指标。