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产科臂丛神经麻痹:单侧分娩起始的周围性损伤是否会显著影响脑发育?

Obstetric Brachial Plexus Palsy: Can a Unilateral Birth Onset Peripheral Injury Significantly Affect Brain Development?

机构信息

Federal University of Rio Grande do Norte/Faculty of Health Sciences of Trairi - UFRN/FACISA, Health of Children , Santa Cruz, Brazil.

Division of Biokinesiology and Physical Therapy, University of Southern California , Los Angeles, CA, US.

出版信息

Dev Neurorehabil. 2020 Aug;23(6):375-382. doi: 10.1080/17518423.2019.1689437. Epub 2020 Jan 6.

Abstract

: Examine brain structure and function in OBPP and relate to clinical outcomes to better understand the effects of decreased motor activity on early brain development. : 9 OBPP, 7 controls underwent structural MRI scans. OBPP group completed evaluations of upper-limb function and functional near-infrared spectroscopy (fNIRS) during motor tasks. : Mean primary motor area volume was lower in both OBPP hemispheres. No volume differences across sides seen within groups; however, Asymmetry Ratio in supplementary motor area differed between groups. Greater asymmetry in primary somatosensory area correlated with lower ABILHAND-Kids scores. fNIRS revealed more cortical activity in both hemispheres during affected arm reach. : Cortical volume differences or asymmetry were found in motor and sensory regions in OBPP that related to clinical outcomes. Widespread cortical activity in fNIRS during affected arm reach suggests reorganization in both hemispheres and is relevant to rehabilitation of those with developmental peripheral and brain injuries.

摘要

研究 OBPP 患者的大脑结构和功能,并将其与临床结果相关联,以更好地了解运动活动减少对早期大脑发育的影响。9 名 OBPP 患者和 7 名对照者接受了结构 MRI 扫描。OBPP 组在运动任务期间完成了上肢功能和近红外光谱 (fNIRS) 的评估。在两个 OBPP 半球中,主要运动区的体积均较低。组内未见两侧体积差异;然而,辅助运动区的不对称比在组间存在差异。初级躯体感觉区的不对称性与 ABILHAND-Kids 评分较低相关。fNIRS 显示在受影响的手臂伸展时,两个半球的皮质活动都增加了。在 OBPP 中发现了与临床结果相关的运动和感觉区域的皮质体积差异或不对称。受影响的手臂伸展时 fNIRS 中观察到的广泛皮质活动表明两个半球的重组,这与发育性外周和脑损伤患者的康复相关。

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