Cohen L G, Roth B J, Wassermann E M, Topka H, Fuhr P, Schultz J, Hallett M
Human Cortical Physiology Unit, National Institute of Neurological Disorders and Stroke, National Institutes of Health, Bethesda, Maryland 20892.
J Clin Neurophysiol. 1991 Jan;8(1):56-65. doi: 10.1097/00004691-199101000-00007.
Basic principles of magnetic stimulation of biological tissues are reviewed. Noninvasive magnetic stimulation of the brain delivered over sensorimotor areas evokes movements and less commonly paresthesias in contralateral limbs. We have evaluated the maps of motor outputs in patients with (1) congenital mirror movements, which resulted in marked derangement of the map of outputs of distal hand muscles with enlarged and ipsilateral representations; (2) amputations, which resulted in plastic reorganization of motor outputs targeting muscles immediately proximal to the stump; (3) spinal cord injury, which also resulted in enlargement of the map of outputs targeting muscles proximal to the lesion level; and (4) hemispherectomy performed at an early age for intractable seizures, which resulted in the remaining hemisphere controlling ipsilateral arm muscles. These results demonstrate the potential for reorganization in motor systems following lesions in the peripheral as well as in the central nervous system.
本文综述了生物组织磁刺激的基本原理。经感觉运动区对大脑进行非侵入性磁刺激可诱发对侧肢体运动，较少情况下可诱发感觉异常。我们评估了以下几种患者的运动输出图谱：（1）先天性镜像运动患者，其导致手部远端肌肉输出图谱明显紊乱，同侧代表区扩大；（2）截肢患者，其导致针对残端近端肌肉的运动输出发生可塑性重组；（3）脊髓损伤患者，其也导致针对损伤水平近端肌肉的输出图谱扩大；（4）幼年时因难治性癫痫接受大脑半球切除术的患者，其导致剩余半球控制同侧手臂肌肉。这些结果表明，外周和中枢神经系统损伤后运动系统具有重组的潜力。
