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颈内动脉闭塞性病变患者因脑自动调节功能受损导致的皮质重组。

Cortical reorganization due to impaired cerebral autoregulation in individuals with occlusive processes of the internal carotid artery.

作者信息

List Jonathan, Hertel-Zens Susan, Kübke Jan Carl, Lesemann Anne, Schreiber Stephan J, Flöel Agnes

机构信息

Department of Neurology, Charité-University Hospital, Berlin, Germany; Center for Stroke Research Berlin, Charité-Universitätsmedizin Berlin, Germany.

Department of Neurology, Charité-University Hospital, Berlin, Germany.

出版信息

Brain Stimul. 2014 May-Jun;7(3):381-7. doi: 10.1016/j.brs.2014.02.006. Epub 2014 Feb 26.

Abstract

BACKGROUND AND PURPOSE

To study the impact of impaired cerebral autoregulation on cortical neurophysiology, long term potentiation (LTP)-like plasticity, motor learning and brain structure.

METHODS

12 patients with unilateral occlusion or severe stenosis of the internal carotid artery were included. Impairment of cerebral autoregulation was determined by vasomotor reactivity in transcranial Doppler sonography. Corticomotor excitability, cortical silent period and LTP-like plasticity were assessed with transcranial magnetic stimulation, motor learning with a force production task, and brain structure with high-resolution MRI of the brain.

RESULTS

In the affected hemisphere, corticomotor excitability was significantly higher, cortical silent period and LTP-like plasticity significantly lower, compared to the contralateral side. No significant difference emerged for motor learning, cortical thickness and white matter integrity between the hemispheres.

CONCLUSION

Despite decreased LTP-like plasticity in the affected hemisphere, motor learning was comparable between hemispheres, possibly due to gamma-aminobutyric-acid (GABA)B-mediated corticomotor excitability changes within the affected hemisphere. Our results may help to develop interventions to beneficially modulate cortical physiology in the presence of cerebral hypoperfusion.

摘要

背景与目的

研究脑自动调节功能受损对皮质神经生理学、长时程增强(LTP)样可塑性、运动学习和脑结构的影响。

方法

纳入12例单侧颈内动脉闭塞或严重狭窄患者。通过经颅多普勒超声中的血管运动反应性来确定脑自动调节功能受损情况。采用经颅磁刺激评估皮质运动兴奋性、皮质静息期和LTP样可塑性,通过力量产生任务评估运动学习,利用脑部高分辨率MRI评估脑结构。

结果

与对侧相比,患侧半球的皮质运动兴奋性显著更高,皮质静息期和LTP样可塑性显著更低。半球间的运动学习、皮质厚度和白质完整性无显著差异。

结论

尽管患侧半球的LTP样可塑性降低,但半球间的运动学习能力相当,这可能是由于患侧半球内γ-氨基丁酸(GABA)B介导的皮质运动兴奋性变化所致。我们的研究结果可能有助于开发干预措施,以便在脑灌注不足的情况下有益地调节皮质生理学。

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