Hazany Saman, Mann Daljit, Bagrodia Neelesh, Krafnick Anthony J, Chu Remy, Shaw Susan, Clark Kristi
Department of Neuroradiology, Keck School of Medicine, University of Southern California, 1500 San Pablo Street, Second Floor Imaging, Los Angeles, CA, 90033, USA.
Rancho Los Amigos National Rehabilitation Center, 7601 Imperial Highway, Downey, CA, 90242, USA.
Childs Nerv Syst. 2023 Feb;39(2):443-449. doi: 10.1007/s00381-022-05664-8. Epub 2022 Sep 10.
Partial preservation of sensory and motor functions in the contralateral extremities after hemispherectomy is likely secondary to cortical reorganization of the remaining hemisphere and can be improved by rehabilitation. This study aims to investigate behavioral and structural cerebral cortical changes that may occur after a 2-week novel robotic rehabilitation program in children with prior anatomic hemispherectomy.
Five patients with prior anatomic hemispherectomy (average age 10.8 years; all female) participated in a 2-week novel robotic rehabilitation program. Pre- and post-treatment (2 time points) high-resolution structural 3D FSPGR (fast spoiled gradient echo) magnetic resonance images were analyzed to measure cortical thickness and gray matter volume using a locally designed image processing pipeline.
Four of the five patients showed improvement in the Fugl-Meyer score (average increase 2.5 + 2.1 SD. Individual analyses identified small increases in gray matter volume near the hand knob area of the primary cortex in three of the five patients. Group analyses identified an increase in cortical thickness near the hand knob area of the primary motor cortex, in addition to other sensorimotor regions.
This small pilot study demonstrates that potentially rehabilitation-associated cortical changes can be identified with MRI in hemispherectomy patients.
大脑半球切除术后对侧肢体感觉和运动功能的部分保留可能继发于剩余半球的皮质重组，且可通过康复得到改善。本研究旨在调查在接受过解剖学大脑半球切除术的儿童中，进行为期2周的新型机器人康复计划后可能发生的行为和大脑皮质结构变化。
5例曾接受解剖学大脑半球切除术的患者（平均年龄10.8岁；均为女性）参与了为期2周的新型机器人康复计划。使用本地设计的图像处理流程，对治疗前和治疗后（2个时间点）的高分辨率结构3D FSPGR（快速扰相梯度回波）磁共振图像进行分析，以测量皮质厚度和灰质体积。
5例患者中有4例Fugl-Meyer评分有所改善（平均增加2.5 + 2.1标准差）。个体分析发现，5例患者中有3例初级皮质手区附近灰质体积有小幅增加。组分析发现，除其他感觉运动区域外，初级运动皮质手区附近皮质厚度增加。
这项小型试点研究表明，大脑半球切除术后患者可通过MRI识别出与康复可能相关的皮质变化。
