Darling Warren G, Pizzimenti Marc A, Rotella Diane L, Ge Jizhi, Stilwell-Morecraft Kimberly S, Morecraft Robert J
Department of Health and Human Physiology, Motor Control Laboratory, The University of Iowa, Iowa City, IA, United States.
Department of Anatomy and Cell Biology, Carver College of Medicine, The University of Iowa, Iowa City, IA, United States.
Front Syst Neurosci. 2021 Mar 18;15:592235. doi: 10.3389/fnsys.2021.592235. eCollection 2021.
We previously reported that rhesus monkeys recover spontaneous use of the more impaired (contralesional) hand following neurosurgical lesions to the arm/hand representations of primary motor cortex (M1) and lateral premotor cortex (LPMC) (F2 lesion) when tested for reduced use (RU) in a fine motor task allowing use of either hand. Recovery occurred without constraint of the less impaired hand and with occasional forced use of the more impaired hand, which was the preferred hand for use in fine motor tasks before the lesion. Here, we compared recovery of five F2 lesion cases in the same RU test to recovery after unilateral lesions of M1, LPMC, S1 and anterior portion of parietal cortex (F2P2 lesion - four cases). Average and highest %use of the contralesional hand in the RU task in F2 cases were twice that in F2P2 cases ( < 0.05). Recovery in the RU task was closely associated with volume and percentage of lesion to caudal (new) M1 (M1c) in both F2 and F2P2 lesion cases. One F2P2 case, with the largest M1c lesion and a large rostral somatosensory cortex (S1r) lesion developed severe contralesional hand non-use despite exhibiting some recovery of fine motor function initially. We conclude that the degree of reduced use of the contralesional hand is primarily related to the volume of M1c injury and that severe non-use requires extensive injury to M1c and S1r. Thus, assessing peri-Rolandic injury extent in stroke patients may have prognostic value for predicting susceptibility to RU and non-use in rehabilitation.
我们之前报道过，当在一项允许使用任意一只手的精细运动任务中对恒河猴进行减少使用（RU）测试时，在对初级运动皮层（M1）和外侧运动前皮层（LPMC）（F2损伤）的手臂/手部表征进行神经外科损伤后，它们能恢复对受损更严重（对侧）手的自发使用。恢复过程中未对受损较轻的手进行限制，且偶尔会强制使用受损更严重的手，而这只手在损伤前是精细运动任务中偏好使用的手。在此，我们将同一RU测试中5例F2损伤病例的恢复情况与M1、LPMC、S1和顶叶皮层前部（F2P2损伤 - 4例）单侧损伤后的恢复情况进行了比较。F2病例在RU任务中对侧手的平均和最高使用百分比是F2P2病例的两倍（<0.05）。在F2和F2P2损伤病例中，RU任务中的恢复都与尾侧（新）M1（M1c）的损伤体积和百分比密切相关。1例F2P2病例，其M1c损伤最大且伴有较大的嘴侧躯体感觉皮层（S1r）损伤，尽管最初表现出一些精细运动功能的恢复，但仍出现了严重的对侧手不使用情况。我们得出结论，对侧手使用减少的程度主要与M1c损伤的体积有关，而严重的不使用需要M1c和S1r受到广泛损伤。因此，评估中风患者罗兰多周围损伤的程度可能对预测康复中出现RU和不使用情况的易感性具有预后价值。
