Klomjai Wanalee, Giron Alain, Mounir El Mendili Mohamed, Aymard Claire, Pradat-Diehl Pascale, Roche Nicolas, Katz Rose, Bayen Eléonore, Lackmy-Vallee Alexandra
Faculty of Physical Therapy, Mahidol University, 73170 Nakonpathom, Thailand.
Sorbonne Université, CNRS, INSERM, Laboratoire d'Imagerie Biomédicale, LIB, F-75005 Paris, France.
Clin Neurophysiol. 2022 Apr;136:1-12. doi: 10.1016/j.clinph.2021.12.016. Epub 2022 Jan 20.
The role of ipsilateral motor cortex efferent pathways in the transmission of voluntary command to spinal motor nuclei remains controversial in humans. In healthy subjects, their implication in cortical control is hidden by predominant role of crossed corticospinal tract. However, evidence from electrophysiological and imaging studies suggest that ipsilateral tracts may contribute to functional recovery after unilateral brain damage. This randomized-sham control study aims to explore to what extent ipsilateral tracts from the undamaged hemisphere may strengthen corticospinal control onto spinal motor networks following stroke.
Anodal transcranial direct current stimulation (tDCS) was combined with monosynaptic H-reflex method to evaluate the variations of reciprocal inhibition (RI) in wrist flexors in 21 stroke participants.
Anodal tDCS decreased RI in wrist flexors in stroke participants in both arms. tDCS unmasks an ipsilateral control from the undamaged hemisphere onto spinal motor networks controlling affected arm muscles in stroke participants. In the unaffected (contralateral) arm, effects in stroke participants were opposite to those induced in healthy subjects.
Stimulation of the undamaged cortex in stroke participants induces modulation of ipsilateral motor networks controlling the hemiparetic side.
Rehabilitation could leverage stimulation of the undamaged hemisphere to enhance motor recovery post stroke.
在人类中,同侧运动皮质传出通路在将自主指令传递至脊髓运动核中的作用仍存在争议。在健康受试者中,其在皮质控制中的作用被交叉皮质脊髓束的主导作用所掩盖。然而,电生理和影像学研究的证据表明,同侧传导束可能有助于单侧脑损伤后的功能恢复。这项随机假对照研究旨在探讨中风后未受损半球的同侧传导束在多大程度上可以加强皮质脊髓对脊髓运动网络的控制。
将阳极经颅直流电刺激(tDCS)与单突触H反射方法相结合,以评估21名中风参与者腕部屈肌中交互抑制(RI)的变化。
阳极tDCS降低了中风参与者双臂腕部屈肌的RI。tDCS揭示了未受损半球对中风参与者中控制患侧手臂肌肉的脊髓运动网络的同侧控制。在未受影响(对侧)手臂中,中风参与者的效应与健康受试者中诱导的效应相反。
刺激中风参与者未受损的皮质会诱导对控制偏瘫侧的同侧运动网络的调节。
康复可以利用对未受损半球的刺激来增强中风后的运动恢复。