Juenger H, Grodd W, Krägeloh-Mann I, Staudt M
Department of Pediatric Neurology and Developmental Medicine, University Children's Hospital, Tübingen, Germany.
Neuropediatrics. 2008 Oct;39(5):252-8. doi: 10.1055/s-0029-1202284. Epub 2009 Mar 17.
In congenital hemiparesis after pre- or perinatally acquired unilateral brain lesions, many patients control their paretic hand via ipsilateral cortico-spinal projections from the contralesional hemisphere. In order to clarify the pattern of basal ganglia activation in case of such a shift of the primary motor cortical representation (M1) of the paretic hand to the contralesional hemisphere, fMRI was performed in eight patients with congenital hemiparesis due to unilateral periventricular white matter lesions and ipsilateral corticospinal projections to the paretic hand (as determined by focal transcranial magnetic stimulation). FMRI during active movements of the paretic hand yielded basal ganglia activation in the ipsilateral (=contralesional) hemisphere, but not in the contralateral (lesioned) hemisphere. Thus, (re-)organization in congenital hemiparesis with ipsilateral cortico-spinal projections includes, in addition to the ipsilateral primary motor cortex (M1), also the ipsilateral basal ganglia - in contrast to the primary somatosensory cortex (S1), which is typically preserved in the affected hemisphere.
在产前或围产期获得性单侧脑损伤后的先天性偏瘫患者中，许多患者通过对侧半球的同侧皮质脊髓投射来控制其患侧手。为了阐明在患侧手的初级运动皮质代表区（M1）向对侧半球转移的情况下基底神经节的激活模式，对8例因单侧脑室周围白质病变导致先天性偏瘫且有同侧皮质脊髓投射至患侧手的患者（通过局灶性经颅磁刺激确定）进行了功能磁共振成像（fMRI）检查。患侧手主动运动期间的fMRI显示同侧（=对侧）半球基底神经节激活，但对侧（病变）半球未激活。因此，在有同侧皮质脊髓投射的先天性偏瘫中，（重新）组织除了包括同侧初级运动皮质（M1）外，还包括同侧基底神经节——这与通常保留在患侧半球的初级躯体感觉皮质（S1）不同。
