From the Department of Radiology, Tianjin Key Laboratory of Functional Imaging (J.Z., L.M., W.Q., N.L., C.Y.) and Department of Neurology, Tianjin Neurological Institute (F.-D.S.), Tianjin Medical University General Hospital, Tianjin, China.
Stroke. 2014 Mar;45(3):788-93. doi: 10.1161/STROKEAHA.113.003425. Epub 2014 Feb 4.
Both structural atrophy and functional reorganization of the primary motor cortex (M1) have been reported in patients with subcortical infarctions affecting the motor pathway. However, the relationship between structural impairment and functional reorganization in M1 remains unclear.
Twenty-six patients exhibiting significant recovery after subcortical infarctions were investigated using multimodal MRI techniques. Structural impairment was assessed via cortical thickness, and functional reorganization was analyzed using task-evoked activation, amplitude of low-frequency fluctuation, and resting-state functional connectivity.
Compared with healthy controls, patients with stroke exhibited reduced cortical thickness in the ipsilesional M1; however, this region exhibited increased task-evoked activation, amplitude of low-frequency fluctuation, and resting-state functional connectivity in these patients. Patients with stroke demonstrated increased task-evoked activation in another ipsilesional M1 region, in which increased amplitude of low-frequency fluctuation and resting-state functional connectivity were observed. The structural and functional changes in M1 were located selectively in the ipsilesional hemisphere.
We provide convincing evidence that indicates extensive functional reorganization in the ipsilesional M1 of patients with chronic subcortical infarctions, including the structurally impaired M1 region.
皮质下梗死影响运动通路的患者，其初级运动皮层（M1）存在结构萎缩和功能重组。然而，M1 中的结构损伤与功能重组之间的关系尚不清楚。
采用多模态 MRI 技术对 26 例皮质下梗死后恢复显著的患者进行了研究。通过皮质厚度评估结构损伤，通过任务诱发激活、低频振幅和静息态功能连接分析功能重组。
与健康对照组相比，卒中患者患侧 M1 的皮质厚度降低；然而，该区域的患者表现出任务诱发激活、低频振幅和静息态功能连接增加。卒中患者在另一个患侧 M1 区域表现出增加的任务诱发激活，观察到增加的低频振幅和静息态功能连接。M1 的结构和功能变化选择性地位于患侧半球。
我们提供了令人信服的证据，表明慢性皮质下梗死患者患侧 M1 存在广泛的功能重组，包括结构受损的 M1 区域。
