Sydney Medical School, The University of Sydney , Sydney, NSW , Australia.
Front Hum Neurosci. 2013 Aug 19;7:500. doi: 10.3389/fnhum.2013.00500. eCollection 2013.
In the past decade, research has demonstrated that cortical plasticity, once thought only to exist in the early stages of life, does indeed continue on into adulthood. Brain plasticity is now acknowledged as a core principle of brain function and describes the ability of the central nervous system to adapt and modify its structural organization and function as an adaptive response to functional demand. In this clinical case study we describe how we used neuroimaging techniques to observe the functional topographical expansion of a patch of cortex along the sensorimotor cortex of a 27-year-old woman following brachial plexus transfer surgery to re-innervate her left arm. We found bilateral activations present in the thalamus, caudate, insula as well as across the sensorimotor cortex during an elbow flex motor task. In contrast we found less activity in the sensorimotor cortex for a finger tap motor task in addition to activations lateralized to the left inferior frontal gyrus and thalamus and bilaterally for the insula. From a pain perspective the patient who had experienced extensive phantom limb pain (PLP) before surgery found these sensations were markedly reduced following transfer of the right brachial plexus to the intact left arm. Within the context of this clinical case the results suggest that functional improvements in limb mobility are associated with increased activation in the sensorimotor cortex as well as reduced PLP.
在过去的十年中，研究表明，皮质可塑性，曾经被认为只存在于生命的早期阶段，实际上确实在成年后仍在继续。大脑可塑性现在被认为是大脑功能的核心原则，它描述了中枢神经系统适应和改变其结构组织和功能的能力，以适应功能需求。在这个临床案例研究中，我们描述了我们如何使用神经影像学技术观察一名 27 岁女性接受臂丛神经转移手术后，其感觉运动皮层上的一块皮层的功能拓扑扩展。在进行肘部弯曲运动任务时，我们发现丘脑、尾状核和脑岛都有双侧激活，同时在感觉运动皮层也有激活。相比之下，在进行手指轻敲运动任务时，我们发现感觉运动皮层的活动较少，此外，激活偏向左侧额下回和丘脑，以及双侧脑岛。从疼痛的角度来看，这位患者在手术前经历了广泛的幻肢痛（PLP），发现右臂臂丛神经转移到完好的左臂后，这些感觉明显减少。在这个临床案例的背景下，结果表明，肢体运动能力的改善与感觉运动皮层的激活增加以及 PLP 的减少有关。
