Department of Physical Therapy, Yeungnam University, Taegu, Republic of Korea.
Eur Neurol. 2010;64(1):9-14. doi: 10.1159/000313976. Epub 2010 Jun 19.
No prior study has reported on the cortical activation pattern in hemiparetic patients with a pontine infarct. The aim of this study was to investigate the cortical activation pattern of hemiparetic patients with a pontine infarct, using functional MRI scanning (fMRI).
Fifteen consecutive patients who showed severe weakness at onset due to a pontine infarct were recruited. The motor function was assessed at the time of the onset of stroke and fMRI scanning was performed (on average 8.9 months after stroke onset). The fMRI was performed during a motor task of timed hand grasp-release movements. From the fMRI, the laterality index was calculated to assess the relative activity in the ipsilateral versus the contralateral primary sensorimotor cortex (SM1).
All patients except for 2 (bilateral SM1 activation) showed contralateral SM1 activation without ipsilateral SM1 activation associated with the affected hand movements. The average laterality index for the affected hand movements among all patients was 0.97.
The fMRI results showed that primarily the contralateral SM1 was activated during affected hand movements. Therefore, it appears that the motor function of the affected hand, in patients with a pontine infarct, recovers mainly via the lateral corticospinal tract.
先前尚无研究报道过脑桥梗死所致偏瘫患者的皮质激活模式。本研究旨在使用功能磁共振成像扫描（fMRI）来研究脑桥梗死偏瘫患者的皮质激活模式。
共纳入 15 例连续的因脑桥梗死而导致发病时严重无力的患者。在卒中发病时进行运动功能评估，并进行 fMRI 扫描（平均在卒中发病后 8.9 个月进行）。fMRI 是在手的定时抓握-释放运动任务期间进行的。从 fMRI 中计算侧化指数，以评估对侧和同侧初级体感运动皮质（SM1）的相对活动。
除 2 例患者（双侧 SM1 激活）外，所有患者在受影响的手运动时均显示出对侧 SM1 激活，而没有同侧 SM1 激活。所有患者受影响的手运动的平均侧化指数为 0.97。
fMRI 结果表明，在受影响的手运动期间，主要激活的是对侧 SM1。因此，脑桥梗死患者受影响的手的运动功能似乎主要通过皮质脊髓侧束恢复。
