Säisänen Laura, Määttä Sara, Julkunen Petro, Niskanen Eini, Kallioniemi Elisa, Gröhn Heidi, Kemppainen Samuli, Lakka Timo A, Lintu Niina, Eloranta Aino-Maija, Vanninen Ritva, Makkonen Ismo, Könönen Mervi
Department of Clinical Neurophysiology, Institute of Clinical Medicine, Faculty of Health Sciences, University of Eastern Finland, Kuopio, Finland.
Department of Clinical Neurophysiology, Kuopio University Hospital, Kuopio, Finland.
Brain Topogr. 2019 May;32(3):504-518. doi: 10.1007/s10548-019-00704-0. Epub 2019 Apr 4.
Motor functions are frequently impaired in Asperger syndrome (AS). In this study, we examined the motor cortex structure and function using navigated transcranial magnetic stimulation (nTMS) and voxel-based morphometry (VBM) and correlated the results with the box and block test (BBT) of manual dexterity and physical activity in eight boys with AS, aged 8-11 years, and their matched controls. With nTMS, we found less focused cortical representation areas of distinct hand muscles in AS. There was hemispheric asymmetry in the motor maps, silent period duration and active MEP latency in the AS group, but not in controls. Exploratory VBM analysis revealed less gray matter in the left postcentral gyrus, especially in the face area, and less white matter in the precentral area in AS as compared to controls. On the contrary, in the right leg area, subjects with AS displayed an increased density of gray matter. The structural findings of the left hemisphere correlated negatively with BBT score in controls, whereas the structure of the right hemisphere in the AS group correlated positively with motor function as assessed by BBT. These preliminary functional (neurophysiological and behavioral) findings are indicative of asymmetry, and co-existing structural alterations may reflect the motor impairments causing the deteriorations in manual dexterity and other motor functions commonly encountered in children with AS.
阿斯伯格综合征（AS）患者的运动功能常受损。在本研究中，我们使用导航经颅磁刺激（nTMS）和基于体素的形态学测量（VBM）检查了运动皮层的结构和功能，并将结果与8名8至11岁患有AS的男孩及其匹配对照组的手动灵巧性箱框测试（BBT）和身体活动情况进行了关联分析。通过nTMS，我们发现AS患者不同手部肌肉的皮层代表区域不那么集中。AS组在运动图谱、静息期持续时间和主动运动诱发电位潜伏期方面存在半球不对称性，而对照组则没有。探索性VBM分析显示，与对照组相比，AS患者左侧中央后回灰质较少，尤其是面部区域，中央前回白质也较少。相反，在右腿区域，AS患者的灰质密度增加。对照组中左侧半球的结构发现与BBT评分呈负相关，而AS组右侧半球的结构与BBT评估的运动功能呈正相关。这些初步的功能（神经生理学和行为学）发现表明存在不对称性，同时存在的结构改变可能反映了导致AS儿童常见的手动灵巧性和其他运动功能恶化的运动障碍。
