Centre de Résonance Magnétique Biologique et Médicale UMR CNRS 6612 Facultéde Médecine, Université de la Méditerranée, Marseille, France.
MAGMA. 2011 Apr;24(2):77-84. doi: 10.1007/s10334-010-0232-9. Epub 2010 Dec 17.
While occurrence of motor cortical reorganization has been clearly demonstrated in patients with multiple sclerosis (MS), it is not yet clear whether this cortical reorganization constitutes a response to cortico-spinal lesions or to more diffuse damage affecting the neuronal network involved in motor act preparation, or both. We proposed to investigate the changes in the activation pattern during a simple motor task devoid of cortico-spinal dysfunction occurring in patients with clinically isolated syndrome (CIS) suggestive of MS.
Among 15 right-handed CIS patients, we selected eight patients with a preserved central motor pathway established by motor evoked potentials. Ten healthy right-handed gender- and age-matched volunteers were also included. After morphological MRI, subjects performed calibrated conjugated finger flexion and extension movements during fMRI acquisition.
In CIS patients, simple movements of the non-dominant hand induced recruitment of the anterior cingulate cortex (BA32) usually involved in complex motor movements. This reorganization was correlated with the diffuse brain tissue damage (brain T₂ lesion load).
These results suggest that at least part of the cortical reorganization observed during very simple tasks in the earliest stage of MS occurs whether or not the efferent pathways are intact.
虽然多发性硬化症（MS）患者的运动皮质重组已经得到明确证实，但目前尚不清楚这种皮质重组是对皮质脊髓损伤的反应，还是对影响运动准备神经元网络的更广泛损伤的反应，或者两者兼而有之。我们建议研究在提示 MS 的临床孤立综合征（CIS）患者中，不伴有皮质脊髓功能障碍的简单运动任务期间的激活模式变化。
在 15 名右利手 CIS 患者中，我们选择了 8 名运动诱发电位证实中央运动通路正常的患者。还纳入了 10 名健康的右利手性别和年龄匹配的志愿者。在形态学 MRI 后，受试者在 fMRI 采集期间进行校准的对指屈肌和伸肌运动。
在 CIS 患者中，非优势手的简单运动引起了通常涉及复杂运动的前扣带皮层（BA32）的募集。这种重组与弥散性脑组织损伤（脑 T₂病变负荷）相关。
这些结果表明，在 MS 的早期阶段，即使传出通路完整，在非常简单的任务中观察到的皮质重组至少部分是存在的。
