Fiori Simona, Staudt Martin, Pannek Kerstin, Borghetti Davide, Biagi Laura, Scelfo Danilo, Rose Stephen E, Tosetti Michela, Cioni Giovanni, Guzzetta Andrea
IRCCS Stella Maris Foundation, Pisa, Italy.
Clinic for Neuropediatrics and Neurorehabilitation, Epilepsy Center for Children and Adolescents, Schön Klinik Vogtareuth, Germany.
Dev Med Child Neurol. 2015 Oct;57(10):977-80. doi: 10.1111/dmcn.12817. Epub 2015 Jun 22.
We report on a patient with mirror movements sustained by a mono-hemispheric fast control of bilateral hand muscles and normal hand function. Transcranial magnetic stimulation of the right motor cortex evoked contractions of muscles in both hands while no responses were observed from the left hemisphere. Somatosensory-evoked potentials, functional magnetic resonance, and diffusion tractography showed evidence of sensorimotor dissociation and asymmetry of corticospinal projections, suggestive of reorganization after early unilateral left brain lesion. This is the first evidence that, in certain rare conditions, good hand function is possible with ipsilateral corticospinal reorganization, supporting the role of unexplored mechanisms of motor recovery.
我们报告了一名患者，其双侧手部肌肉由单半球快速控制维持镜像运动且手部功能正常。经颅磁刺激右侧运动皮层可诱发双手肌肉收缩，而左侧半球未观察到反应。体感诱发电位、功能磁共振成像和弥散张量成像显示了感觉运动分离和皮质脊髓投射不对称的证据，提示早期左侧单侧脑损伤后发生了重组。这是首个证据表明，在某些罕见情况下，同侧皮质脊髓重组可实现良好的手部功能，支持了未被探索的运动恢复机制的作用。
