Department of Hand Surgery, Huashan Hospital, Shanghai, People's Republic of China.
J Neurosurg. 2010 Jul;113(1):133-40. doi: 10.3171/2010.1.JNS09448.
Peripheral nerve injury in a limb usually causes intrahemispheric functional reorganization of the contralateral motor cortex. Recently, evidence has been emerging for significant interhemispheric cortical plasticity in humans, mostly from studies of direct cortical damage. However, in this study, a long-range interhemispheric plasticity was demonstrated in adults with brachial plexus avulsion injury (BPAI) who had received a contralateral cervical nerve transfer, and this plasticity reversed the BPAI-induced intrahemispheric cortical reorganization.
In this study, 8 adult male patients with BPAI were studied using PET scanning.
The results indicated that the right somatomotor cortices, which may contribute to the control of the injured limb before brachial plexus deafferentation, still played an important role when patients with BPAI tried to move their affected limbs, despite the fact that the contralateral C-7 nerve transfer had been performed and the peripheral output had changed dramatically. Such findings are consistent with the results of the authors' previous animal study.
The brain may try to restore the control of an injured limb to its original cortex area, and a complicated change of peripheral pathway also can induce long-range interhemispheric cortical reorganization in human motor cortex.
肢体周围神经损伤通常会导致对侧大脑运动皮质的半球内功能重组。最近，越来越多的证据表明人类大脑存在显著的大脑半球间皮质可塑性，这些证据主要来自于对直接皮质损伤的研究。然而，在这项研究中，臂丛神经撕脱伤（BPAI）患者接受了对侧颈神经转移术，这些患者出现了长程的大脑半球间可塑性，这种可塑性逆转了 BPAI 引起的半球内皮质重组。
本研究采用 PET 扫描对 8 名成年男性 BPAI 患者进行了研究。
结果表明，右侧运动皮质在臂丛神经失神经支配之前可能有助于控制损伤肢体，尽管已经进行了对侧 C-7 神经转移，外周输出已经发生了巨大变化，但当 BPAI 患者试图移动其受损肢体时，该皮质仍发挥着重要作用。这些发现与作者之前的动物研究结果一致。
大脑可能试图将受损肢体的控制恢复到其原始皮质区域，而外周通路的复杂变化也可以诱导人类运动皮质的长程大脑半球间皮质重组。
