Pihko Elina, Nevalainen Päivi, Vaalto Selja, Laaksonen Kristina, Mäenpää Helena, Valanne Leena, Lauronen Leena
Brain Research Unit, O.V. Lounasmaa Laboratory, Aalto University School of Science, Espoo, Finland.
Hum Brain Mapp. 2014 Aug;35(8):4105-17. doi: 10.1002/hbm.22462. Epub 2014 Feb 12.
Cerebral palsy (CP) is characterized by difficulty in control of movement and posture due to brain damage during early development. In addition, tactile discrimination deficits are prevalent in CP. To study the function of somatosensory and motor systems in CP, we compared the reactivity of sensorimotor cortical oscillations to median nerve stimulation in 12 hemiplegic CP children vs. 12 typically developing children using magnetoencephalography. We also determined the primary cortical somatosensory and motor representation areas of the affected hand in the CP children using somatosensory-evoked magnetic fields and navigated transcranial magnetic stimulation, respectively. We hypothesized that the reactivity of the sensorimotor oscillations in alpha (10 Hz) and beta (20 Hz) bands would be altered in CP and that the beta-band reactivity would depend on the individual pattern of motor representation. Accordingly, in children with CP, suppression and rebound of both oscillations after stimulation of the contralateral hand were smaller in the lesioned than intact hemisphere. Furthermore, in two of the three children with CP having ipsilateral motor representation, the beta- but not alpha-band modulations were absent in both hemispheres after affected hand stimulation suggesting abnormal sensorimotor network interactions in these individuals. The results are consistent with widespread alterations in information processing in the sensorimotor system and complement current understanding of sensorimotor network development after early brain insults. Precise knowledge of the functional sensorimotor network organization may be useful in tailoring individual rehabilitation for people with CP.
脑性瘫痪(CP)的特征是由于早期发育期间的脑损伤而导致运动和姿势控制困难。此外,触觉辨别缺陷在脑性瘫痪中很普遍。为了研究脑性瘫痪中躯体感觉和运动系统的功能,我们使用脑磁图比较了12名偏瘫型脑性瘫痪儿童与12名发育正常儿童的感觉运动皮层振荡对正中神经刺激的反应性。我们还分别使用体感诱发电场和导航经颅磁刺激确定了脑性瘫痪儿童患侧手的主要皮层躯体感觉和运动代表区。我们假设,α(10赫兹)和β(20赫兹)频段的感觉运动振荡反应性在脑性瘫痪中会发生改变,并且β频段反应性将取决于运动代表的个体模式。因此,在脑性瘫痪儿童中,对侧手刺激后,两个振荡的抑制和反弹在受损半球比完整半球小。此外,在三名具有同侧运动代表的脑性瘫痪儿童中的两名中,患侧手刺激后两个半球均不存在β频段而非α频段调制,这表明这些个体中存在异常的感觉运动网络相互作用。这些结果与感觉运动系统中信息处理的广泛改变一致,并补充了对早期脑损伤后感觉运动网络发育的当前理解。对功能性感觉运动网络组织的精确了解可能有助于为脑性瘫痪患者量身定制个性化康复方案。