Veldema Jitka, Bösl Kathrin, Nowak Dennis Alexander
HELIOS Klinik Kipfenberg, Kipfenberg, Germany.
HELIOS Klinik Kipfenberg, Kipfenberg, Germany; Department of Neurology, University Hospital, Philipps-University, Marburg, Germany.
Neural Plast. 2017;2017:6171903. doi: 10.1155/2017/6171903. Epub 2017 Feb 14.
. To investigate the relationship between changes of cortical hand motor representation and motor recovery of the affected hand in subacute stroke. . 17 patients with motor impairment of the affected hand were enrolled in an in-patient neurological rehabilitation program. Hand motor function tests (Wolf Motor Function Test, Action Research Arm Test) and neurophysiological evaluations (resting motor threshold, motor evoked potentials, motor map area size, motor map area volume, and motor map area location) were obtained from both hands and hemispheres at baseline and two, four, and six weeks of in-patient rehabilitation. . There was a wide spectrum of hand motor impairment at baseline and hand motor recovery over time. Hand motor function and recovery correlated significantly with (i) reduction of cortical excitability, (ii) reduction in size and volume of cortical hand motor representation, and (iii) a medial and anterior shift of the center of gravity of cortical hand motor representation within the contralesional hemisphere. . Recovery of motor function of the affected hand after stroke is accompanied by definite changes in excitability, size, volume, and location of hand motor representation over the contralesional primary motor cortex. These measures may serve as surrogate markers for the outcome of hand motor rehabilitation after stroke.
研究亚急性卒中患者皮质手部运动代表区变化与患手运动恢复之间的关系。17例患手存在运动功能障碍的患者参加了一项住院神经康复项目。在基线期以及住院康复的第2周、第4周和第6周，对患者双手及双侧半球进行手部运动功能测试（沃尔夫运动功能测试、动作研究臂测试）和神经生理学评估（静息运动阈值、运动诱发电位、运动代表区面积大小、运动代表区体积以及运动代表区位置）。基线期患手运动功能障碍程度范围广泛，且随着时间推移患手运动功能逐渐恢复。手部运动功能及恢复与以下因素显著相关：（i）皮质兴奋性降低；（ii）皮质手部运动代表区面积大小及体积减小；（iii）患侧半球内皮质手部运动代表区重心向内侧和前方移位。卒中后患手运动功能的恢复伴随着对侧初级运动皮质上手部运动代表区在兴奋性、面积大小、体积及位置方面的明确变化。这些指标可作为卒中后手运动康复效果的替代标志物。
