多发性硬化症中与运动相关的大脑失活受损:半球间神经元抑制功能病理学的进一步证据。
Impairment of movement-associated brain deactivation in multiple sclerosis: further evidence for a functional pathology of interhemispheric neuronal inhibition.
作者信息
Manson S C, Wegner C, Filippi M, Barkhof F, Beckmann C, Ciccarelli O, De Stefano N, Enzinger Christian, Fazekas F, Agosta F, Gass A, Hirsch J, Johansen-Berg H, Kappos L, Korteweg T, Polman C, Mancini L, Manfredonia F, Marino S, Miller D H, Montalban X, Palace J, Rocca M, Ropele S, Rovira A, Smith S, Thompson A, Thornton J, Yousry T, Frank J A, Matthews P M
机构信息
Centre for Functional Magnetic Resonance Imaging of the Brain, University of Oxford, Oxford, UK.
出版信息
Exp Brain Res. 2008 May;187(1):25-31. doi: 10.1007/s00221-008-1276-1. Epub 2008 Jan 31.
Motor control demands coordinated excitation and inhibition across distributed brain neuronal networks. Recent work has suggested that multiple sclerosis (MS) may be associated with impairments of neuronal inhibition as part of more general progressive impairments of connectivity. Here, we report results from a prospective, multi-centre fMRI study designed to characterise the changes in patients relative to healthy controls during a simple cued hand movement task. This study was conducted at eight European sites using 1.5 Tesla scanners. Brain deactivation during right hand movement was assessed in 56 right-handed patients with relapsing-remitting or secondary progressive MS without clinically evident hand impairment and in 60 age-matched, healthy subjects. The MS patients showed reduced task-associated deactivation relative to healthy controls in the pre- and postcentral gyri of the ipsilateral hemisphere in the region functionally specialised for hand movement control. We hypothesise that this impairment of deactivation is related to deficits of transcallosal connectivity and GABAergic neurotransmission occurring with the progression of pathology in the MS patients. This study has substantially extended previous observations with a well-powered, multicentre study. The clinical significance of these deactivation changes is still uncertain, but the functional anatomy of the affected region suggests that they could contribute to impairments of motor control.
运动控制需要分布式脑神经网络中协调的兴奋和抑制。最近的研究表明,作为更普遍的渐进性连接障碍的一部分,多发性硬化症(MS)可能与神经元抑制受损有关。在此,我们报告一项前瞻性、多中心功能磁共振成像(fMRI)研究的结果,该研究旨在描述在简单的提示手部运动任务期间,患者相对于健康对照的变化。这项研究在欧洲的八个地点使用1.5特斯拉扫描仪进行。在56名复发缓解型或继发进展型MS且无临床明显手部损伤的右利手患者以及60名年龄匹配的健康受试者中,评估了右手运动期间的脑失活情况。与健康对照相比,MS患者在同侧半球中央前回和中央后回中专门用于手部运动控制的功能区域,与任务相关的失活减少。我们假设这种失活障碍与MS患者病理进展过程中发生的胼胝体连接和GABA能神经传递缺陷有关。这项研究通过一项样本量充足的多中心研究,大大扩展了先前的观察结果。这些失活变化的临床意义仍不确定,但受影响区域的功能解剖表明,它们可能导致运动控制受损。