Quentin Romain, Awosika Oluwole, Cohen Leonardo G
Human Cortical Physiology and Neurorehabilitation Section, NINDS, Bethesda, MD, United States.
Human Cortical Physiology and Neurorehabilitation Section, NINDS, Bethesda, MD, United States; University of Cincinnati, College of Medicine, Department of Neurology and Rehabilitation Medicine, Cincinnati, OH, United States.
Handb Clin Neurol. 2019;163:473-483. doi: 10.1016/B978-0-12-804281-6.00025-2.
The frontal lobe plays a crucial role in human motor behavior. It is one of the last areas of the brain to mature, especially the prefrontal regions. After a brief historical perspective on the perceived dichotomy between the view of the brain as a static organ and that of a plastic, constantly changing structure, we discuss the stability/plasticity dilemma including examples of documented cortical reorganization taking place at multiple spatial and temporal scales. We pose that while plasticity is needed for motor learning, stability of the system is necessary for storage and maintenance of memorized skills. We discuss how this plasticity/stability dilemma is resolved along the life span and after a brain injury. We then examine the main challenges that clinicians have to overcome to promote recovery of function in patients with brain lesions, including attempts to use neurostimulation techniques as adjuvant to training-based customary neurorehabilitation.
额叶在人类运动行为中起着至关重要的作用。它是大脑中最后成熟的区域之一,尤其是前额叶区域。在简要回顾了关于大脑是静态器官与可塑性、不断变化结构这两种观点之间的二分法的历史观点之后,我们讨论了稳定性/可塑性困境,包括在多个空间和时间尺度上记录到的皮质重组的例子。我们认为,虽然可塑性对于运动学习是必要的,但系统的稳定性对于记忆技能的存储和维持是必不可少的。我们讨论了这种可塑性/稳定性困境在整个生命周期以及脑损伤后是如何解决的。然后,我们研究了临床医生为促进脑损伤患者功能恢复必须克服的主要挑战,包括尝试使用神经刺激技术作为基于训练的传统神经康复的辅助手段。