Jang Sung Ho, You Sung H, Ahn Sang Ho
Department of Physical Medicine & Rehabilitation, School of Medicine, Yeungnam University, Taegu, Republic of Korea.
NeuroRehabilitation. 2007;22(2):117-22.
This study highlights the effects of a comprehensive neurorehabilitation (CN) on neuroplasticity and motor recovery in a 25 years old adult with right hippocampal sclerosis and the temporal lobectomy and amygdalotomy.
The patient received 8-month course of comprehensive neurorehabilitation, comprised of five times/week. Motor behavioral and 1.5 T functional magnetic resonance imaging (fMRI) tests were implemented to determine the restoration of motor function and neuroplasitic changes, respectively. In fMRI measure, a laterality index (LI) was used to determine any shift in the symmetry of cortical activation between the hemispheres. Additionally, motor behavioral changes were measured to probe long-term retention of learned motor skills at the 6-month post-treatment follow-up test.
Motor behavioral tests showed that comprehensive neurorehabilitation enhanced functional reaching, grasping, and hand manipulation skills, which were well retained even at the 6-month post-treatment. Baseline fMRI showed asymmetry of the contralesional sensori-motor cortex (SMC) activation (Laterality index score: 0.54), but was restored to normal symmetry (Lateral index: 1.0) during affected hand movement after comprehensive neurorehabilitation.
Our novel findings suggest that comprehensive neurorehabilitation may facilitate restitution of normal symmetry of cortical activation, thereby enhancing motor function. This case provides the first neuroimaging evidence about a long-term comprehensive neurorehabilitation-induced neuroplasticity of the individual with a complex brain injury in the literature.
本研究着重探讨了综合神经康复(CN)对一名25岁患有右侧海马硬化并接受颞叶切除术和杏仁核切开术的成年人神经可塑性和运动恢复的影响。
该患者接受了为期8个月的综合神经康复疗程,每周进行五次。分别实施运动行为测试和1.5T功能磁共振成像(fMRI)测试,以确定运动功能的恢复和神经可塑性变化。在fMRI测量中,使用偏侧性指数(LI)来确定半球间皮质激活对称性的任何变化。此外,在治疗后6个月的随访测试中测量运动行为变化,以探究所学运动技能的长期保持情况。
运动行为测试表明,综合神经康复增强了功能性够物、抓握和手部操作技能,即使在治疗后6个月这些技能仍得到良好保持。基线fMRI显示对侧感觉运动皮层(SMC)激活不对称(偏侧性指数得分:0.54),但在综合神经康复后受影响手运动期间恢复到正常对称(偏侧指数:1.0)。
我们的新发现表明,综合神经康复可能有助于恢复皮质激活的正常对称性,从而增强运动功能。该病例在文献中提供了首个关于长期综合神经康复诱导复杂脑损伤个体神经可塑性的神经影像学证据。