Motor Performance Laboratory, Department of Integrative Physiology, The University of Iowa, Iowa City, IA 52242, USA.
Exp Brain Res. 2010 May;202(3):529-42. doi: 10.1007/s00221-010-2157-y. Epub 2010 Jan 28.
The purpose of this study was to determine if recovery of neurologically impaired hand function following isolated motor cortex injury would occur without constraint of the non-impaired limb, and without daily forced use of the impaired limb. Nine monkeys (Macaca mulatta) received neurosurgical lesions of various extents to arm representations of motor cortex in the hemisphere contralateral to the preferred hand. After the lesion, no physical constraints were placed on the ipsilesional arm/hand and motor testing was carried out weekly with a maximum of 40 attempts in two fine motor tasks that required use of the contralesional hand for successful food acquisition. These motor tests were the only "forced use" of the contralesional hand. We also tested regularly for spontaneous use of the contralesional hand in a fine motor task in which either hand could be used for successful performance. This minimal intervention was sufficient to induce recovery of the contralesional hand to such a functional level that eight of the monkeys chose to use that hand on some trials when either hand could be used. Percentage use of the contralesional hand (in the task when either hand could be used) varied considerably among monkeys and was not related to lesion volume or recovery of motor skill. These data demonstrate a remarkable capacity for recovery of spontaneous use of the impaired hand following localized frontal lobe lesions. Clinically, these observations underscore the importance of therapeutic intervention to inhibit the induction of the learned nonuse phenomenon after neurological injury.
这项研究的目的是确定在不限制未受损肢体的情况下，并且不每天强制使用受损肢体的情况下，是否可以从孤立的运动皮层损伤中恢复受损手部的神经功能。九只猴子（猕猴）接受了不同程度的手术损伤，导致对优势手对侧半球运动皮层的手臂代表区的损伤。损伤后，对同侧手臂/手没有施加任何物理限制，每周进行一次运动测试，最多可以在两个需要使用对侧手成功获取食物的精细运动任务中进行 40 次尝试。这些运动测试是对对侧手进行的唯一“强制使用”。我们还定期测试在一个精细运动任务中对侧手的自发使用情况，任何一只手都可以成功完成任务。这种最小的干预措施足以使对侧手恢复到这样的功能水平，以至于八只猴子在任何一只手都可以使用的情况下，有些情况下会选择使用那只手。对侧手的使用百分比（在任何一只手都可以使用的任务中）在猴子之间差异很大，与损伤体积或运动技能的恢复无关。这些数据表明，在手部局部额叶损伤后，自发使用受损手的恢复能力非常强。临床上，这些观察结果强调了治疗干预的重要性，以抑制神经损伤后习得性非使用现象的诱导。
