LUNAM, Université d'Angers, Laboratoire d'Ingénierie des Systèmes Automatisés (LISA) - EA4094, F-49000, France; LUNAM, Université d'Angers, CHU Angers, Département de Médecine Physique et de Réadaptation, F-49933, France.
Res Dev Disabil. 2013 Oct;34(10):3487-96. doi: 10.1016/j.ridd.2013.07.008. Epub 2013 Aug 6.
In patients with cerebral palsy (CP), neuroimaging studies have demonstrated that passive movement and action-observation tasks have in common to share neuronal activation in all or part of areas involved in motor system. Action observation with simultaneous congruent passive movements may have additional effects in the recruitment of brain motor areas. The aim of this functional magnetic resonance imaging (fMRI) study was to examine brain activation in patients with unilateral CP during passive movement with and without simultaneous observation of simple hand movement. Eighteen patients with unilateral CP (fourteen male, mean age 14 years and 2 months) participated in the study. Using fMRI block design, brain activation following passive simple opening-closing hand movement of either the paretic or nonparetic hand with and without simultaneous observation of a similar movement performed by either the left or right hand of an actor was compared. Passive movement of the paretic hand performed simultaneously to the observation of congruent movement activated more "higher motor areas" including contralesional pre-supplementary motor area, superior frontal gyrus (extending to premotor cortex), and superior and inferior parietal regions than nonvideo-guided passive movement of the paretic hand. Passive movement of the paretic hand recruited more ipsilesional sensorimotor areas compared to passive movement of the nonparetic hand. Our study showed that the combination of observation of congruent hand movement simultaneously to passive movement of the paretic hand recruits more motor areas, giving neuronal substrate to propose video-guided passive movement of paretic hand in CP rehabilitation.
在脑瘫（CP）患者中，神经影像学研究表明，被动运动和动作观察任务具有共同的特点，即共同激活运动系统中全部或部分区域的神经元。在同时进行的协调被动运动中观察动作可能会对大脑运动区域的募集产生额外的影响。本功能磁共振成像（fMRI）研究的目的是在单侧 CP 患者中，检查在被动简单开合手运动期间同时观察简单手部运动时的大脑激活情况。18 名单侧 CP 患者（14 名男性，平均年龄 14 岁零 2 个月）参与了这项研究。使用 fMRI 块设计，比较了患侧手在进行无视频引导的患侧手被动简单开合运动与患侧手在同时观察演员的相似运动（左手或右手）时的大脑激活情况，以及患侧手在进行同时观察协调运动时的被动简单开合运动的大脑激活情况。与无视频引导的患侧手被动简单开合运动相比，患侧手同时进行协调运动的观察会激活更多的“高级运动区”，包括对侧预备运动区、额上回（延伸至运动前区）以及顶叶和顶下叶区域。与非患侧手的被动运动相比，患侧手的被动运动募集了更多同侧的感觉运动区。我们的研究表明，同时观察协调的手部运动与患侧手的被动运动相结合，可以募集更多的运动区，为提出 CP 康复中患侧手的视频引导被动运动提供了神经学基础。
