Artzi Moran, Shiran Shelly Irene, Weinstein Maya, Myers Vicki, Tarrasch Ricardo, Schertz Mitchell, Fattal-Valevski Aviva, Miller Elka, Gordon Andrew M, Green Dido, Ben Bashat Dafna
Functional Brain Center, The Wohl Institute for Advanced Imaging, Tel Aviv Sourasky Medical Center, 6 Weizmann Street, 64239 Tel Aviv, Israel; Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.
Department of Radiology, Tel Aviv Sourasky Medical Center, 6 Weizmann Street, 64239 Tel Aviv, Israel.
Neural Plast. 2016;2016:8615872. doi: 10.1155/2016/8615872. Epub 2016 May 19.
The brain has a remarkable capacity for reorganization following injury, especially during the first years of life. Knowledge of structural reorganization and its consequences following perinatal injury is sparse. Here we studied changes in brain tissue volume, morphology, perfusion, and integrity in children with hemiplegia compared to typically developing children, using MRI. Children with hemiplegia demonstrated reduced total cerebral volume, with increased cerebrospinal fluid (CSF) and reduced total white matter volumes, with no differences in total gray matter volume, compared to typically developing children. An increase in cortical thickness at the hemisphere contralateral to the lesion (CLH) was detected in motor and language areas, which may reflect compensation for the gray matter loss in the lesion area or retention of ipsilateral pathways. In addition, reduced cortical thickness, perfusion, and surface area were detected in limbic areas. Increased CSF volume and precentral cortical thickness and reduced white matter volume were correlated with worse motor performance. Brain reorganization of the gray matter within the CLH, while not necessarily indicating better outcome, is suggested as a response to neuronal deficits following injury early in life.
大脑在受伤后，尤其是在生命的最初几年，具有显著的重组能力。关于围产期损伤后结构重组及其后果的知识较为匮乏。在此，我们使用磁共振成像（MRI）研究了偏瘫儿童与正常发育儿童相比，脑组织体积、形态、灌注和完整性的变化。与正常发育儿童相比，偏瘫儿童的全脑体积减小，脑脊液（CSF）增加，全白质体积减小，而全灰质体积无差异。在病变对侧半球（CLH）的运动和语言区域检测到皮质厚度增加，这可能反映了对病变区域灰质损失的补偿或同侧通路的保留。此外，在边缘区域检测到皮质厚度、灌注和表面积减小。脑脊液体积增加、中央前回皮质厚度增加和白质体积减小与更差的运动表现相关。CLH内灰质的脑重组虽不一定表明预后更好，但被认为是对生命早期损伤后神经元缺陷的一种反应。
